Burns Nursing Review Flashcards

Comprehensive vocabulary flashcards covering burn classifications, TBSA estimation methods, phases of burn management, fluid resuscitation formulas, wound debridement, and topical antimicrobial treatments based on the lecture notes.

Burn

Cell destruction of the layers of the skin and the resultant depletion of fluid and electrolytes.

Localized Burns

Burns where the body's response is localized or contained to the injured area.

Extensive Burns

Burns involving 25% or more of the total body surface area (TBSA), resulting in a systemic response that affects all major systems of the body.

First Degree Burn (Superficial-Partial Thickness)

Involves the epidermis and possibly a portion of the dermis. Characterized by tingling, hyperesthesia, pain soothed by cooling, reddened skin that blanches with pressure, dry surface with minimal or no edema, possible blisters, and complete recovery within a week without scarring.

Second Degree Burn (Deep-Partial Thickness)

Involves the epidermis, upper dermis, and a portion of deeper dermis. Characterized by pain, hyperesthesia, sensitivity to cold air, blisters, a mottled red base, weeping surface, and edema; recovery takes 2 to 4 weeks with some scarring and depigmentation.

Third Degree Burn (Full-Thickness)

Involves the epidermis, entire dermis, and sometimes subcutaneous tissue, connective tissue, muscle, and bone. It is insensate/pain-free, dry, pale white, leathery or charred, and requires eschar sloughing and skin grafting.

Minor Burn Injury

Second-degree burns of < 15% TBSA in adults or < 10% in children, or third-degree burns of < 2% TBSA not involving special care areas, excluding electrical, inhalation, or trauma injuries.

Moderate, Uncomplicated Injury

Second-degree burns of 15-25% TBSA in adults or 10-20% in children, or third-degree burns of < 10% TBSA not involving special care areas.

Major Burn Injury

Second-degree burns > 25% TBSA in adults or > 20% in children, all burns > 10% TBSA involving eyes, ears, face, hands, feet, perineum, or joints, as well as all inhalation, electrical, or concurrent trauma injuries.

Lund and Browder (L&B) Method

A precise method of estimating burn size that modifies body segment percentages according to age using a diagram divided into representative percentage sections.

Rule of 9's

A standardized method used to calculate TBSA burned in adults and children by assigning percentage values (multiples of 9%) to major body regions.

Palm Method

A technique to estimate scattered burns where the size of the patient's palm is considered approximately 1% of TBSA.

Thermal Burns

The most common type of burn, caused by exposure to flames, hot liquids, steam, or direct contact with hot objects.

Chemical Burns

Tissue damage caused by contact, ingestion, or inhalation of acids or alkali, which can lead to systemic toxicity through cutaneous absorption.

Electrical Burns

Internal and cutaneous tissue damage caused by heat generated as electrical energy passes through the body, associated with ventricular fibrillation, muscle contractions, and fractures.

Carbon Monoxide Poisoning

Poisoning caused by inhaling a gas with 200 times greater affinity for hemoglobin than oxygen, forming carboxyhemoglobin and presenting with bright cherry red skin, lips, and mucosal membranes.

Zone of Coagulation

The point of maximum damage in a burn; the innermost zone of injury where cellular death occurs.

Zone of Stasis

The middle area of a burn injury characterized by inflammation, tissue injury, and decreased tissue perfusion.

Zone of Hyperemia

The outermost burn zone where tissue perfusion is increased and sustains the least amount of tissue damage.

Emergent / Resuscitative Phase

The initial burn phase starting at the time of injury through the first 24-48 hours, ending with complete fluid resuscitation to prevent hypovolemic shock.

Acute / Immediate / Diuretic Phase

The phase occurring 2-5 days post-injury that begins when the client is hemodynamically stable and diuresis starts, ending upon full wound closure.

Rehabilitative / Convalescent Phase

The final phase of burn care spanning from wound closure to the return of optimal physical, functional, and psychological functioning.

Parkland / Baxter Formula

A fluid resuscitation calculation using Lactated Ringer's Solution: $4\,\text{mL} \times \text{kg body weight} \times \%\text{ TBSA burned}$, with half administered in the first 8 hours and the rest over the next 16 hours.

Brooke Army Formula

A fluid calculation for Day 1 consisting of colloids ($0.5\,\text{mL} \times \text{kg} \times \%\text{ TBSA}$), Lactated Ringer's ($1.5\,\text{mL} \times \text{kg} \times \%\text{ TBSA}$), and $2000\,\text{mL}$ 5% Dextrose in water for insensible loss.

Curling's Ulcer

A gastrointestinal stress ulcer resulting from diminished blood flow to the GI tract following major burn injuries.

Hydrotherapy

Wound cleansing via immersion, showering, or spraying for 30 minutes or less at $37.8^\circ\text{C}$ to minimize sodium loss and encourage movement of extremities.

Natural Debridement

Spontaneous separation of dead tissue from underlying viable tissue caused by bacterial liquefaction of collagen fibrils during the first or second post-burn week.

Mechanical Debridement

The removal of eschar using instruments like surgical scissors, scalpels, and forceps, or via wet-to-dry dressings carried to the point of pain and bleeding.

Surgical Debridement

An operative procedure involving primary excision of full-thickness skin down to fascia or shaving of burned skin layers down to viable, bleeding tissue.

Escharotomy

A lengthwise surgical incision made through restrictive burn eschar to relieve compartment pressure and restore circulation in circumferential burns.

Fasciotomy

An incision extending through subcutaneous tissue and deep fascia, performed under general anesthesia when tissue perfusion is not restored by escharotomy.

Silver Sulfadiazine (Silvadene)

The most bactericidal topical agent with minimal eschar penetration; applied 1 to 3 times daily and may cause transient leukopenia and pseudoeschar.

Mafenide Acetate (Sulfamylon)

A topical agent that penetrates eschar and is the choice for electrical burns; application can be painful and may lead to metabolic acidosis.

Silver Nitrate 0.5% Solution

A bacteriostatic and fungicidal solution that does not penetrate eschar, stains surfaces black or gray, and requires remoistening every 2 hours.

Autografting

Permanent wound coverage utilizing a thin layer of the client's own unburned skin applied directly to the excised wound site.

Allograft (Homograft)

A temporary biological wound covering made from donated human cadaver skin harvested within 24 hours of death.

Xenograft (Heterograft)

A temporary biological wound covering using pig (porcine) skin harvested after slaughter and replaced every 2 to 5 days.