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NUR 211 ( LATEST 2024 / 2025 ) BURNS BURTRAM | QUESTIONS AND ANSWERS INCLUDED

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NUR 211 Burns Burtram

1. What factors increase morbidity in burn patients?
Answer
-Burns covering more than 50% of body surface area
-Inhalation injuries
-Very young and elderly patients
-Additional injuries

2. What layer of skin do you need to have for your skin to regenerate?
Answer
Dermis (at least some of it)

3. What is the function of the skin?
Answer
-Protection from infection
-Prevention of loss of body fluids
-Thermoregulation
-Production of vitamin D
-Excretion
-Determination of identity
-Sensation reception

4. What happens to the skin as we age?
Answer
-Flattened dermal-epidermal junction
-Dermal and subcutaneous atrophy
-Reduced microcirculation
-*thinned skin, predisposition to deeper burns, and delayed or poor healing*
-decreased ability to tolerate burn stress *(underlying dz process can complicate)*

5. What are the mechanisms of burns?

,Answer
-Thermal
-Chemical
-Electrical
-Radiation (sunburns, nuclear incident, cancer tx)
-Inhalation injury occurs about 20-50% of the time with skin injury

6. What is the most recorded mechanism of burn injury in the US?
Answer
thermal (about 90%)

7. What is thermal injury?
Answer
-Skin damaged by contact with heat
>Flame
>Scalding liquids
>Heat source like a heater
>Steam injuries

8. What determines the severity of thermal burns?
Answer
-Duration of contact
-Temperature of agent
• ‘Risk of injury temperature > 40° C (104° F)
-Amount of tissue exposed
-Age of patient

9. What happens to the liquid in our bodies with a thermal burn if the temperature is high
enough?

Answer
Anything liquid in our body turns into a solid (coagulates)

,10. What is the average temperature of a water heater?
Answer
140° F

(120° F - recommended setting)

11. What are examples of thermal injury?
Answer
flame (e.g., house fires, ignition of clothing, explosion of gases), scalding liquids (e.g., water,
cooking oil, grease), steam (e.g., car radiators, cooking pots, industrial equipment), or direct
contact with a heat source (e.g., space heater, metal).

12. Why are the young and elderly at increased risk?
Answer
Thin skin, loss of sensation (like from DM), etc.

13. How can chemical burns take place?
Answer
-Contact
-Inhalation of fumes
-Ingestion or injection

14. What is dangerous about chemical burns?
Answer
-*Systemic* and local effects

-*Must be completely removed or neutralized or damage continues*

15. How do we treat chemical burns on site?
Answer
-Recommended to rinse it off despite the agent (alkali vs acid)
-Do not touch the chemical on the other person
-Brush off a powder with gloved hands, never rub. Can use a washcloth to brush off. Remove
clothing. Flush skin with saline or water. 15 minutes if on skin. 30 min if in the eye. Cover with

, dry sterile dressing until other orders. The longer the chemical on the skin, the worse the burn. If
show up to the ED covered in the chemical, they have to be decontaminated outside before they
can enter to prevent injuries to others via inhalation.

16. What determines the severity of chemical burns?
Answer
-Type of agent
-Volume of agent
-Duration of contact
-Concentration of agent

17. What are the types of chemicals that can cause injury?
Answer
-Alkalies (lye, lime, wet cement, ammonia)
-Acids (house cleaners)
-Organic compounds (gas, diesel fuel)

18. What type of chemical causes the most damage?
Answer
Alkalies are the worst. Cause *severe edema and fluid loss.* *Liquefy the tissue causing
liquefaction necrosis.*

19. What would you assess in a meth lab related burn?
Answer
-Thermal and chemical burn injury pattern
-A vague or inconsistent injury history
-Burns to the face and hands
-Signs of agitation or substance withdrawal

-Patient is more likely to be a substance abuser...screen for withdrawal to give proper tx

20. High vs low voltage burns?
Answer
-High > 1000 volts

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