Skin Review
What vitamin is produced by the skin when exposed to sunlight?
Vitamin D
What two factors are used to determine the severity of a burn?
Body Surface Area and Depth
What does ABCDE stand for?
A - airway (w/ c spine protection)
B - breathing
C - circulation
D - disability
E - environment
What is one challenge protein loss from a burn injury creates?
Ability to hold fluid in the vasculature to regulate blood pressure and perfuse organs.
Great catch! You saw that your burn patient had not been ordered a high protein diet and lifted this up to the Doc!
Gain +100 points.
What are the three layers of the skin?
Epidermis, Dermis, Hypodermis
What three factors affect the severity of a burn?
1. Agent
2. Temperature
3. Length of Exposure
What type of temperature interventions are required for burns?
Initially the sight of the burn should be cooled to stop damage progression. After core body temperature must be maintained through use of warming IV fluids, warm blankets, and a warm environment.
Why does edema occur with a burn injury?
Damage to the vasculature increases permeability causing fluid to shift into the 3rd space causing swelling.
Yikes....your nurse used your pound in weight not kg to determine your parkland formula and caused pulmonary edema from excessive fluid intake!
Lose 200 points.
Name four of the five functions of skin.
1. Protection
2. Regulation
3. Sensation
4. Vitamin D Production
5. Identity
What layers are affected by the following classifications: superficial thickness, partial thickness, full thickness, and deep full thickness?
Superficial - only the epidermis
Partial Thickness - entire epidermis and part of the dermis
Full Thickness - destruction of the entire epidermis and dermis
Deep Full Thickness - All layers of the skin as well as damage to the bone, muscles, and tendons
Using the rule of 9's, what is the TBSA if you receive a report that an adult has partial thickness burns to the chest and left thigh?
27% (18% chest, 9% front left leg)
What happens with K levels in the body when a burn injury occurs?
Initially levels rise due to cell death and release of potassium. After the initial 24 hours then levels tend to drop.
Great work - you used to 5 P's (pallor, pulselessness, pain, parathesia, paralysis) to correctly assess the circulation status of your burn patient.
Gain +300 points
Which layers of the skin can regrow and which cannot?
Epidermis can, the dermis and hypodermis cannot
Name 3 of the key differences between a superficial partial burn and a deep partial burn.
1. pink, moist & blanchable verse red and dry
2. blisters verse no blisters
3. extreme pain verse less severe pain
4. no scar verse scar
5. heals within 21 days verse 6 weeks
As you rehydrate a patient, what is a major concern you should regularly assess for?
airway edema
Why might someone hear crackles in the lungs for a burn patient?
Smoke and heat can damage the vasculature of the lungs causing leakage of fluid into the pleural space.
Well done - you did not allow the patients parent who did not have any external burns to leave without a lung assessment for smoke damage from their house fire!
Gain +400 points
What layer of skin contains blood vessels, sweat glands, and nerves?
Dermis
What is a major concern for a deep full thickness burn?
Compartment Syndrome
What fluid is given during the resuscitation phase?
LR
What is a digestive concern for burn patients?
Paralytic ileus due to reduced blood flow to the GI tract.
You done did your final jeopardy of nursing school.
Gain +750 points