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Wound Care Final Exam: Questions & Solutions (A+)

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Wound Care Final Exam: Questions & Solutions (A+)

Causes of burns Right Ans - scalding
flame
chemical
electrical
radiation
friction

Scalding Right Ans - -water or grease
-young or elderly--> esp those with compromised sensation
-patterns

Have water heater regulated at 120 degrees

In children:
-over head cause pulled something
-burn pattern typically downward with splash marks from accidental burns
-if circumferential tends to be abuse

Insensate pts:
-circumferential burns on feet and ankles from bath water


Will continue to burn until the source is removed and the skin cooled down

Flame Right Ans - inhalation injury
explosion

Pattern deps on what victim was wearing and the accelerant of the burn
-non-flame resistant clothes stick and create deeper burns


Inhalation the heat gen from combustion can cause sig thermal injury to the
upper airway
-soot can mech clog and irritate the airways causing reflex
bronchoconstriction
-lung damage

,Will continue to burn until the source is removed and the skin cooled down
-need to know what caught on fire: clothes vs actual skin

chemical Right Ans - -antifreeze
-household cleaning agents
-commerical agents

Results when skins comes in contact with a strong acid, alkaline, or corrosive
material
-everyday household cleaners

Never apply butter to a burn: acts as an insulator and trap the heat

Will continue to burn until the source is completely flushed away from
neutralized
-eye wash stations

Electrical Right Ans - pattern of least of resistance
-travels through nerves and vessels
-most serious damage occur along this pathway
--> heart could dev arrhythmias
--> damage to the eye from the electrical arc
--> thermal burns from clothes catching

Lightening: kills more than all natural disasters every year
-look like a feather: lichtenburg

Will see an entry/exit wound

Household voltage: 1000 V
Job related voltage: 1000+ V--> results in loss of limb or life

Radiation Right Ans - sunburn


Radiation therapy

Sunburn Right Ans - a form of erythema in which skin cells are damaged by
exposure to the ultraviolet rays in sunlight

,Damage it does over time!!!

-delayed UV induced redness by increase in BF to the affected area
-peaks at 8-24 hours following exposure
-caused by direct/indirect damage to spec cellular targets from photchem
reactions and prostaglandins leading to vasodilation and edema
-biologic response modifiers released by both keratinocytes and lymphocytes
play role
-redness= total failure of sun protection

1st= pink
2nd= blister

Radiation therapy Right Ans - caused by acute or chronic effects of ionizing
radiation

may involve:
-skin
underlying soft tissue
even deep structures such as bone

Friction or mechanical Right Ans - road rash
-MVA, bikes, motorcycles, skate boards
-abrasion of the skin: minor--> very painful

More common in younger people

Need moist wound healing to relieve discomfort and heal faster

Typically stays in 2nd

Old vs. new burn depth classification Right Ans - old: degrees
new: thickness

Defined by # of layers involved

Superficial burn = 1st degree Right Ans - epidermis only

, Dry, erythema and pain: nerve irritation and inflammed

Surface is typically dry it heals in sev days to weeks

EX: sunburn without blisters

Not included in total surface burn assessment

Partial thickness burn = 2nd degree Right Ans - characteristics:
-epidermis and dermis
-superficial partial and deep partial

Superficial partial thickness burn Right Ans - characteristics:
-epidermis and papillary dermis
-erythema, serous blisters
-blanchable, painful: exposure to sensory nerves

Surface can be moist

Heals in 14-21 days by epithelialization with minimal to no scarring

Deep partial thickness burn Right Ans - characteristics:
-epidermis and reticular dermis
-mottled white to pink
-less blanchable, painful

Hallmark:
-destruction of dermal vascular plexus: greatly diminished capillary return
with no or sluggish blanching when pressure is applied to the wound bed

Nerve endings are damaged = reduced sensation

Deeper burns tend to be dry with diminished fluid exudate compared with
more superficial burns

Heal time: weeks or progress to 3rd degree which would require grafting

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