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Burns

1. If someone has been burned, fluid seeps out into the tissue, why?
increased capillary permeability (vessels are leaking)

2. When the fluid seeps into the tissue, what happened to the blood pressure and the pulse?

Explain why.
pulses increases to compensate for decreased volume. BP decreased because there is no
volume. Less volume less pressure

3. Why does the cardiac output decrease when the fluid seeps out into the tissue?
volume is decreased in vascular space therefore there is less volume to pump out

4. During this phase (when the fluid is seeping into the tissue), is this client in a fluid volume

deficit or fluid volume excess?

deficit

5. When a client is in a fluid volume deficit, why does their urine output decrease?
decreased renal perfusion and the kidneys are trying to conserve what they have

6. After a major burn, when fluid is seeping out into the tissue, why is it important that ADH

and aldosterone are secreted?

help retain na and h2o and increase vascular volume

7. What is the treatment for carbon monoxide poisoning? Explain why.

100% o2. Because the client is hypoxic. By giving 100% O2 we are increasing the probability that
O2 will bind with the hemoglobin before carbon monoxide can.

8. When a client has any type of upper body burns, why do we have to worry about the

airway?
when you have burns in this area you have to worry about airway damage and edema

9. What are the s/s of airway injury in the burn client?

Singed nose hair, singed facial hair, soot, you know the black stuff all over the face, coughing up
stuff with dark specs or the secretions could be really black, blisters found on the oral/pharyngeal
mucosa.

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10. Explain the Rule of Nines.

Estimate of total Body Surface Area that has been burned: Head=9; each Arm=9; each Leg=18;
Anterior trunk=18; Posterior trunk=18; Genitalia=1.

11. Using the Consensus formula, what percent volume of fluid is given the 1st 8 hours, 2nd 8
hours, and 3rd 8 hours?
Calculate what is needed the first 24 hours and give ½ during first 8 hours; 2nd 8 hours give ¼ of
total volume; 3rd 8 hours give ¼ of total volume.

12. What measurement is the best to way evaluate fluid volume status in the burn client?
Intake and output because we are expecting the client to gain weight based on the amount of
fluid that we are administering

13. How will an IV with albumin help fight shock? What are the risks with albumin

administration?
it helps hold fluid in the vascular space

14. Explain the difference between the tetanus toxoid and the tetanus immune globulin.
The immune globulin gives immediate protection because it is the injection of antibodies
(passive immunity). Toxoid: Body has to make antibodies (active immunity).

15. What is the purpose of the escharotomy?

relieves pressure and restores circulation

16. What electrolyte do we worry about with burns?

K because when the cells rupture they leak K and the client can be hyperkalemic

17. Why do clients with burns take a GI protectant medication, like an antacid or proton-pump

inhibitor?
for stress ulcers

18. What is the purpose of measuring gastric residual?

to ensure the supplement is moving through the GI tract

19. Why are multiple antibiotics used when treating burns?

to prevent resistance of bacteria. Don’t want bacteria to build tolerance

20. When a client has an electrical injury, they are at a high risk for what arrhythmia?
v fib

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21. How long is the client at risk for a life-threatening arrhythmias?

24 hours

22. Why can a client with an electrical burn have kidney failure?
toxins build up and damage kidneys. Electricity destroys any circulation. Kidneys are very
vascular