NUR 421 TEST 4 QUESTIONS AND ANSWERS
____________burns are caused by exposure to dry sources (fire or flame) or wet
sources (scalds) and account for 80% of burns
they produce microvascular and inflammatory responses within minutes and these
responses last 2-3 days
inflammatory mediators increase vascular permeability and cause fluid and electrolytes
to leak into the interstitial space --> edema - Answers :thermal
How do burns affect our vascular permeability - Answers :serotonin and histamine are
released and increase vascular permeability which leads to intravascular fluid shifts to
the interstitial space
What is our concern with increased vascular permeability? - Answers :fluid shifts can
result in hypovolemia/burn shock
_____________ burns are the result of exposure to acid, alkali, or organic substances
the extent of injury depends on the amount and concentration of the substance, the
length of exposure, and the mechanism of chemical action - Answers :chemical
difference in acidic burns vs alkaline burns - Answers :*acidic*: eschar
*alkaline*: protein liquification, soupy wound that continues to the lower vascular bed
and damages it
an acid substance causes an ____________ type of wound, resulting from coagulation
necrosis - Answers :eschar
this prevents continued tissue damage beneath the layer of eschar
T/F alkaline substances cause more tissue damage than acid substances - Answers
:true, alkalis causes protein liquefaction, producing a soupy wound that allows
continued tissue damage into deeper structures
Organic substances (cresols and phenols) produce a thermal component and may be
absorbed systemically, which produces: - Answers :renal and hepatic toxicity, and can
affect the resp and cardiac systems if inhaled
T/F a direct electrical current causes more harm than an alternating current - Answers
:false; an alternating current causes more severe injury because it produced tetanic
muscle contractions that do not allow disengagement from the source; direct current
hurls the person away from the source
,what kind of burn is a sunburn - Answers :radiation
____________ energy produces cellular toxins in the body
the greatest the exposure, the worse the damage will be - Answers :radiant
conditions that increase susceptibility to frostbite injuries - Answers :-decreased muscle
and fat tissue
-poor nutrition
-inability to generate sufficient body heat through physical activity
-alcohol and drug abuse
-diminished ability to shiver
-old age (vasconstriciton and inability to generate heat)
pathophys of frostbite - Answers :ice crystals form in the body and cause microvascular
stasis and occlusion
which burn is characterized by deep penetration of tissues and necrosis continuing for
several hours after injury? - Answers :alkaline burn
what determines the extent of chemical burns? - Answers :type of chemical,
concentration of the chemical, how long it was in contact with the skin, pre-existing
conditions
top three primary goals in treating burn patients *in order of priorty* - Answers :1). stop
the burning: put out fire, remove chemical, stop burning process
2). protect the airway: edema can occlude the airway and compromise the patient
3). assess extent of injuries and take appropriate measures to treat them
burns are classified according to: - Answers :depth of injury and extent of body surface
area involved
superficial burns include only the ___________ tissues
ex. sunburn - Answers :epidermal
_____________ ________________ burns involves the epidermis and the superficial
layer of the dermis
ex. brief contact with hot objects - Answers :superficial partial-thickness
What tissues do deep partial-thickness burns involve? - Answers :epidermis and deep
layer of the dermis
_________________ burns involve the epidermis, dermis and subq tissues
, ex. flames, electricity or chemicals - Answers :full-thickness
Subdermal (deep full-thickness) burns involve: - Answers :all the layers of the skin and
may include injury to the muscle, tendons or bone
the spontaneous progression of a burn wound into deeper tissue after the initial burn
insult (ex. partial to full thickness)
viable tissue becomes nonviable and extends the depth of the wound - Answers :wound
conversion
risk factors for wound conversion - Answers :impaired oxygenation to the tissues,
infection, mechanical trauma and malnutrition
each thermal burn consists of three zones of injury from the most severe inner area to
the least severe outer area of the burn: - Answers :*zone of coagulation*: area of
greatest damage, closest to the heat source and all the tissue is damaged
*zone of stasis*: central area of the wound, only some tissue is damaged, can easily
convert to nonviable tissue is blood flow isn't restored (wound conversion)
*zone of hyperemia*: outermost area, blanches with pressure and heals in 7-10 days,
red in color d/t prolonged inflammation; can go into wound conversion with prolonged
hypoperfusion
The extent of a burn injury is expressed by the percentage of ____________ burned
this does not include superficial burns - Answers :total body surface area (TBSA)
another guide to calculate TBSA is the rule of nines:
quick way to determine extent of burns, less accurate in children who have different
TBSA than adults - Answers :head is 9% (face 4.5 back of head 4.5)
each upper extremity is 9% (anterior/posterior 4.5)
each lower extremity is 18%
the back is 18%
the trunk is 18% (chest 9 and abd 9)
perineum is 1%
The most accurate guide in determining the extent of injury is the
_______________________ chart, which adjusts TBSA according to age - Answers
:Lund and Bowder
How does one calculate irregularly shaped burns or burns that occur in patches? -
Answers :use the palmar surface of the patient's hand to measures (accounts for 0.5%
of TBSA)
____________burns are caused by exposure to dry sources (fire or flame) or wet
sources (scalds) and account for 80% of burns
they produce microvascular and inflammatory responses within minutes and these
responses last 2-3 days
inflammatory mediators increase vascular permeability and cause fluid and electrolytes
to leak into the interstitial space --> edema - Answers :thermal
How do burns affect our vascular permeability - Answers :serotonin and histamine are
released and increase vascular permeability which leads to intravascular fluid shifts to
the interstitial space
What is our concern with increased vascular permeability? - Answers :fluid shifts can
result in hypovolemia/burn shock
_____________ burns are the result of exposure to acid, alkali, or organic substances
the extent of injury depends on the amount and concentration of the substance, the
length of exposure, and the mechanism of chemical action - Answers :chemical
difference in acidic burns vs alkaline burns - Answers :*acidic*: eschar
*alkaline*: protein liquification, soupy wound that continues to the lower vascular bed
and damages it
an acid substance causes an ____________ type of wound, resulting from coagulation
necrosis - Answers :eschar
this prevents continued tissue damage beneath the layer of eschar
T/F alkaline substances cause more tissue damage than acid substances - Answers
:true, alkalis causes protein liquefaction, producing a soupy wound that allows
continued tissue damage into deeper structures
Organic substances (cresols and phenols) produce a thermal component and may be
absorbed systemically, which produces: - Answers :renal and hepatic toxicity, and can
affect the resp and cardiac systems if inhaled
T/F a direct electrical current causes more harm than an alternating current - Answers
:false; an alternating current causes more severe injury because it produced tetanic
muscle contractions that do not allow disengagement from the source; direct current
hurls the person away from the source
,what kind of burn is a sunburn - Answers :radiation
____________ energy produces cellular toxins in the body
the greatest the exposure, the worse the damage will be - Answers :radiant
conditions that increase susceptibility to frostbite injuries - Answers :-decreased muscle
and fat tissue
-poor nutrition
-inability to generate sufficient body heat through physical activity
-alcohol and drug abuse
-diminished ability to shiver
-old age (vasconstriciton and inability to generate heat)
pathophys of frostbite - Answers :ice crystals form in the body and cause microvascular
stasis and occlusion
which burn is characterized by deep penetration of tissues and necrosis continuing for
several hours after injury? - Answers :alkaline burn
what determines the extent of chemical burns? - Answers :type of chemical,
concentration of the chemical, how long it was in contact with the skin, pre-existing
conditions
top three primary goals in treating burn patients *in order of priorty* - Answers :1). stop
the burning: put out fire, remove chemical, stop burning process
2). protect the airway: edema can occlude the airway and compromise the patient
3). assess extent of injuries and take appropriate measures to treat them
burns are classified according to: - Answers :depth of injury and extent of body surface
area involved
superficial burns include only the ___________ tissues
ex. sunburn - Answers :epidermal
_____________ ________________ burns involves the epidermis and the superficial
layer of the dermis
ex. brief contact with hot objects - Answers :superficial partial-thickness
What tissues do deep partial-thickness burns involve? - Answers :epidermis and deep
layer of the dermis
_________________ burns involve the epidermis, dermis and subq tissues
, ex. flames, electricity or chemicals - Answers :full-thickness
Subdermal (deep full-thickness) burns involve: - Answers :all the layers of the skin and
may include injury to the muscle, tendons or bone
the spontaneous progression of a burn wound into deeper tissue after the initial burn
insult (ex. partial to full thickness)
viable tissue becomes nonviable and extends the depth of the wound - Answers :wound
conversion
risk factors for wound conversion - Answers :impaired oxygenation to the tissues,
infection, mechanical trauma and malnutrition
each thermal burn consists of three zones of injury from the most severe inner area to
the least severe outer area of the burn: - Answers :*zone of coagulation*: area of
greatest damage, closest to the heat source and all the tissue is damaged
*zone of stasis*: central area of the wound, only some tissue is damaged, can easily
convert to nonviable tissue is blood flow isn't restored (wound conversion)
*zone of hyperemia*: outermost area, blanches with pressure and heals in 7-10 days,
red in color d/t prolonged inflammation; can go into wound conversion with prolonged
hypoperfusion
The extent of a burn injury is expressed by the percentage of ____________ burned
this does not include superficial burns - Answers :total body surface area (TBSA)
another guide to calculate TBSA is the rule of nines:
quick way to determine extent of burns, less accurate in children who have different
TBSA than adults - Answers :head is 9% (face 4.5 back of head 4.5)
each upper extremity is 9% (anterior/posterior 4.5)
each lower extremity is 18%
the back is 18%
the trunk is 18% (chest 9 and abd 9)
perineum is 1%
The most accurate guide in determining the extent of injury is the
_______________________ chart, which adjusts TBSA according to age - Answers
:Lund and Bowder
How does one calculate irregularly shaped burns or burns that occur in patches? -
Answers :use the palmar surface of the patient's hand to measures (accounts for 0.5%
of TBSA)
