Still Goin'
Burns:
Describe the degree, depth and characteristics of superficial thickness burns
1. Degree - First
2. Depth - Epidermis
3. Characteristics:
A. Pain
B. Redness
C. Mild swelling
This should be maintained when changing dressings of burn patients
Sterility
These are signs and symptoms of adequate peripheral perfusion after burn trauma
1. Cap refill
2. Adequate pulses
Gentamicin poses this type of toxicity threat
Nephrotoxicity
This is what the glomeruli of the kidneys filter out
Creatinine
These are the high nutritional needs of burn patients, especially in the acute phase of burn management.
1. High calories
2. High protein
For burn patients you should monitor their oxygenation and administer O2 for signs of hypoxia such as ??
Restlessness
This is what can happen to the kidneys if hypovolemia occurs
Blood flow to the kidneys is decreased, causing renal ischemia; acute kidney injury may develop
Cervical spine injuries are commonly associated with electrical burns. These are the priorities after electrical burns
1. Airway management
2. Stabilization of the cervical spine
These are the abnormal findings with hemodialysis to report to the provider
1. Hypotension
2. Muscle cramps
3. Loss of blood
4. Hepatitis
Burns:
Describe the degree, depth and characteristics of deep partial thickness burns
1. Degree - Third
2. Depth - Dermis (reticular region)
3. Characteristics:
A. White
B. Leathery
C. Relatively painless
This is the care you need to provide to the extremities of burn patients
1. Elevate the affected extremities on pillows
2. Spread out the fingers so that the tissue does not stick together
3. Individually wrap fingers in dressings
This is what happens to kidney function with full-thickness and major electrical burns
Myoglobin (from muscle cell breakdown) and hemoglobin (from RBC breakdown) are released into the blood stream and block renal tubles
These are the nursing management protocols for hemodialysis
1. Decrease the volume of fluid being removed and infusion of 0.9% saline solution
2. Avoid excess anticoagulation
3. Reduce the ultrafiltration rate and administering fluids
For peritoneal dialysis, these are the abnormal findings to report to the provider
1. Cloudy-appearing peritoneal effluent (which is a sign of peritonitis)
2. Observe for hernia development
3. Lower back pain
4. Bleeding
Burns:
Describe the degree, depth and characteristics of full thickness burns
1. Degree - Third
2. Depth - Hypodermis (subcutaneous tissue)
3. Characteristics:
A. Charred
B. Insensate
C. Eschar formation
Burns:
Describe the degree, depth and characteristics of superficial partial thickness burns
1. Degree - Second
2. Depth - Dermis (papillary region)
3. Characteristics:
A. Pain
B. Blisters
C. Splotchy skin
D. Severe swelling
Provide a breakdown of the Rules of Nines in adults
1. Arms are 9% (4.5% each side)
2. Legs are 18% (9% each side)
3. Upper torso 18% (9% front and back each)
4. Lower torso 18% (9% front and back each)
5. Head 9% (4.5% front and back each)
6. Genitals and neck 1%
These are some ways to treat hyperkalemia in acute kidney injury
1. Kayexalate (check bowel sounds before administration)
2. IV calcium
3. IV sodium bicarb
4. IV insulin + IV D50 (dextrose)
These are the nursing management protocols for peritoneal dialysis
1. Orthopedic binders and regular exercise program for strengthening the back muscles
2. Check BP and hematocrit
3. Elevate head of bed
4. Check abdomen for distention
5. Have patient lay on side
6. No kinks in tubing
7. If high protein and malnutrition - may need to terminate PD temporarily or sometimes permanently
Complications of burns, what to monitor for
1. Dysrhythmias
2. Hypovolemic shock
3. Monitor for ischemia, paresthesias and necrosis
4. Monitor for signs of respiratory distress (agitation, anxiety, restlessness, change in the rate or character of breathing
5. Examine any sputum for carbon
6. Monitor the adequacy of fluid replacement - check hourly urine output
Phases of AKI (acute kidney injury)
1. Prerenal
2. Intrarenal
3. Postrenal
Causes of prerenal acute kidney injury
Decreased blood flow
1. Hypovolemia
2. Decreased cardiac output
3. Decreased peripheral vascular resistance
4. Decreased renovascular blood flow
Causes of intrarenal acute kidney injury
Infection
1. Nephrotoxic injury
2. Interstitial nephritis
3. Prolonged prerenal ischemia (glomerulonephritis, among others)
Causes of postrenal acute kidney injury
Obstruction
1. BPH (benign prostatic hyperplasia
2. Bladder cancer
3. Calculi formation
4. Neuromuscular disorders
5. Prostate cancer
6. Spinal cord disease
7. Strictures
8. Trauma (back, pelvis, perineum)