DKA labs/ABGs

Urine positive for large amount of ketones; ABGs:

metabolic acidosis; Elevated K+; Extremely high
blood glucose

HHNS labs/EKG/urine

Urine osmolality and specific gravity will be very

high; Serum osmolality greater than or equal to
320 mOsm/kg (normal 278-300); Elevated K+;
Urinalysis shows no evidence of ketones; Hgb and
Hct will appear high; EKG: Peaked T-waves;
Patient will be lethargic

DKA assessment findings

Severe Hyperglycemia: at least 300, often a lot

higher (even 1000+); 3 Ps (polyphagia, polyurea,
polydipsia); Weakness, fatigue, lethargy, malaise;
Kussmauls respirations; Nausea and vomiting

HHNS assessment findings

Severe hyperglycemia; No ketoacidosis; Severe

dehydration; Low BP; Tachycardia

DKA medical interventions

IV fluids: D5 w/ insulin and K+; Electrolyte

correction - protocol; Insulin: IV drips, then SC;
Cardiac monitor

DKA nursing interventions

Neuro Checks; Seizure precautions:

cerebral edema can occur, especially in young
adults; Frequent assessments; Monitor lab results;
Follow protocols to give insulin and correct
electrolytes

HHNS nursing interventions

IV fluids: First NS bolus, Then D5 w/ insulin and

K+; Cardiac monitor; Glucose monitoring at least
hourly; Electrolyte protocols; Strict I and O; Insulin
SC once drip is dcd.

What is HHNS?

Life threatening, hyperglycemic emergency

accompanied by: hyperosmolality; Severe
dehydration; Alterations in neurologic status
without ketoacidosis; Primarily a complication of
Diabetes Type II

Why is cardiac monitoring a key component of

treatment for DKA and HHNS?

Both have an increased K+ levels

What is the absolute first intervention that must be

done in HHNS before treating the high blood
glucose level?

First NS bolus
Then D5 w/ insulin and K+

Is D5 hypo or hyper tonic?

Hypo

Why do IV drips for patients with diabetes

emergencies (DKA and HHNS) contain both
insulin and potassium? Why do you give
potassium even though the K+ level in the labs
may be too high?

Insulin move potassium into the cells, these

patients usually have polyuria and that decreases
the K+ levels; Because once the insulin pushes
the K+ into the cells the K+ levels will drop

3 abnormalities in metabolism of DKA

Failure of glucose to enter cells; Metabolism of fat

for energy and conversion of free fatty acids to
ketone bodies in the liver; Acceleration of
gluconeogenesis in the liver (glucose production
from noncarbohydrate sources usually
breakdown of muscle tissue)

Main causes of DKA?

Primarily a complication of Type I Diabetes; Too

little insulin for the patients needs; Skipping
doses; Too many carbs for insulin dose; New
onset diabetes; Increased glucose production by
liver (often when patient is sick / stressed)

Main causes of HHNS?

Anything that leads to dehydration or relative

insulin deficiency in someone with type 2 diabetes:
Acute febrile illnesses; Non-compliance with
diabetes care; Glucocorticoid (steroid) use;
Medications that cause dehydration; Meds that
cause insulin resistance.

What is the best way to treat the blood glucose so

it goes up and stays up?

???

Once glucose and dehydration are treated, what

types of meds will be ordered for type 1 vs type 2
diabetes?

???

Signs / symptoms of hypoglycemia. What is the

best way to treat the blood glucose so it goes up
and stays up?

???

Which patients are at highest risk to develop either

Diabetes insipidus and SIADH?

Head injury patients

Nursing interventions and patient teaching for

SIADH

Hypertonic IV solutions (3% Saline); Diuretics;

Seizure precautions; Daily weights, I & O. Monitor
and replace electrolytes prn; Restrict fluids (6001000 ml/day); Demeclocycline (Declomycin)
inhibits the effect of ADH in the kidneys;
Medication teaching and precautions

With Fluid deprivation tests what labs to measure?

When do you discontinue the test? How do you
use this test to assess for diabetes insipidus?

Monitor serum sodium, Monitor K+, check urine

specific gravity; until 3-5% of body wt is lost;
Weigh client frequently during test (q hour)

Diabetes insipidus labs

Up to 18 L/day of very dilute urine (specific gravity

of 1.001 1.005); No abnormal substances in
urine (such as protein, glucose)

SIADH labs

Low sodium; Decreased serum sodium, increased

urine sodium; Decreased serum osmolality;
increased urine osmolality

Relationship between illness, stress, and high

blood glucose. Why are DKA and HHNS most
likely to occur when a diabetic person is sick?

???

Key vital sign issues in myxedema coma?

decreased everything BP, HR, flat t-waves

Myxedema interventions

In ICU; Often needs ventilator support; Meds to

increase BP and HR; Cytomel fast acting thyroid
hormone replacement within 6 hours; Check
temp and BP frequently; Warm blankets; Monitor
LOC

What causes myxedema coma in patients with

hypothyroidism?

Severe untreated or under treated hypothyroidism

(Takes months to develop)

Synthroid

???

Key vital sign issues in thyroid storm

Severe HTN, Tachycardia, dysrhythmias,

Temp > 102 F

What makes these potentially fatal? Remember

there is a 50% mortality rate for untreated thyroid
storm.

Seizures???

What are the 2 main complications that are

extremely dangerous after a thyroidectomy?

Decreased calcium: Watch for tetany (accidental

removal of parathyroid gland) and Respiratory
obstruction from hemorrhage or edema

What should the nurse do to prevent / manage

complications of a thyroidectomy?

Test for low Ca w/ Chvosteks sign, Trousseaus

sign and have Ca gluconate readily accessible;
Assess for hoarseness / resp distress; Suction at
bedside; Trach kit at bedside; O2

Patient teaching for radioactive iodine therapy

Radiation precautions not required for small doses;

Large doses, patient needs radiation precautions;
Total or subtotal thyroidectomy may be indicated

Contraindications for radioactive iodine therapy

Pregnancy

Which meds are given to treat thyroid storm?

Beta blockers, PTU or Tapazole

What is the main disadvantage to using thyroid

hormone blocking meds (PTU, tapazole) in thyroid
storm?

Takes weeks for the full effect

What meds / interventions are used to correct

temperature and cardiac issues because with a
thyroid storm?

Beta blockers (IV) and Cardiac monitoring

Supplementation guidelines for

hypoparathyroidism

Supplement CA 1.5-3gm/day and Vit D; Teach that

supplements must be taken every day for the rest
of the patients life

What are the causes of hypoparathyroidism?

Cause unknown unless related to thyroidectomy

Major complications of hypoparathyroidism

Fractures or serious dental problems, tetany

(tingling of the lips, fingertips, feet), muscle
spasms/cramps, GI symptoms, difficulty
swallowing

Major complications of hypo and

hyperparathyroidism

Can cause softening of the bones, frequent kidney

stones and / or fractures, Polyuria (early sign), GI
issues, bone pain, fractures, muscle weakness

Lab abnormalities in hypoparathyroidism

Decreased Ca and PTH and Increased

Phosphorus

Lab abnormalities in hyperparathyroidism

Elevated Ca and PTH and Decreased phosphorus

Main, life-threatening complications of

pheochromocytoma

Stroke and dysrhythmias

Vital sign abnormalities in pheochromocytoma

Increased HR and very high BP

Signs and symptoms of pheochromocytoma

HA, anxiety, insomnia, feeling jittery, flushed,

diaphoretic

Steroids given for Addisons disease +

considerations

Hydrocortisone (cortef) and Fludrocortisone

(flourinef); 100mg hydrocortisone IM in
emergency; Give with food/milk to avoid GI
irritation; GI distress, may need antacid; Dont skip
doses. If taken greater than a week, must taper off;
Assess for K+ and glucose instability; May need to
adjust insulin when on steroids; Regular eye
exams; Protect from infections (can mask
presence infections); Weigh daily; Too much
steroid could cause Cushingoid symptoms

Assessment findings in a patient with Addisons

disease

Weak, dizzy, tired, orthostatic hypotension, low

blood sugar, weak thready pulse, cold pale skin or
hyperpigmentation (bronze look)

Expected lab results for Addisons disease

Elevated K+, Decreased Na+, Low blood glucose

What is the biggest risk for people with Addisons

disease whether it is untreated or being treated
with steroids?

Addisonian Crisis which could cause shock and

cardiac arrest

Patient teaching for Cushings disease

Protect from exposure to infection; Monitor for s &

s of infection; Good skin care

Dietary interventions for Cushings disease

Low Na, high protein and vitamins to support

immune system; Limit fluids. May need a specific
fluid restriction; Limit foods that raise blood
glucose.

What are the causes of Cushings disease /

syndrome.

#1 cause is adrenal tumor (causing

hypersecretion of steroids); Medical interventions
with high dose steroids (Cushings syndrome);
Pituitary tumor (secretes ACTH, produces
adrenal hyperplasia and hypersecretion)

Assessment findings in Cushings disease

including expected lab results.

Persistent hyperglycemia & insulin resistance;

Muscle wasting (thin limbs) and weakness;
Osteoporosis (fractures); Ecchymosis;
Hypertension; Abnormal fat distribution (moon
face, buffalo hump, truncal obesity); Skin infections
and poor wound healing; Mood swings

Expected lab results in Cushings disease

Elevated glucose levels, Elevated cortisol,

Elevated Na+, Decreased K+

Rule of nines (math question on this). Be able to

calculate the TBSA of a burn from an image or a
description.

Head 9%; Each arm 9%; Anterior torso 18%;

Posterior torso 18%; Each leg 18%;
Genitals/perineum 1%

Superficial Thickness burn (like sunburn)

Heal in 3-6 days; Epidermis only; Erythema, mild

edema, and pain

Partial Thickness burn

Heal in 10 days to 3 weeks; Entire epidermis and

varying depths of the dermis

Superficial partial-thickness burn

Painful; red and moist - blisters; very painful

Deep partial-thickness burn

Red and waxy white appearance; The patient will

experience pain with deep pressure but will have
no pinprick sensation

Full Thickness burn

Can take months to heal; Entire epidermal and

dermal layers of the skin; Hard, dry. Leathery and
White in color.

Deep Full thickness burn

All tissues; Expose muscle, bone and, tendons

Superficial (1st degree)

Partial Thickness (2nd degree)

Deep Partial Thickness (2nd degree)

Full Thickness (3rd Degree)

What would you as the nurse do immediately if

someone experiences a burn outside the hospital?

Soak areas briefly with cool water; Remove

anything that could potentially become restrictive
or could retain heat (clothing/rings); Do not remove
any material that is melted or adherent to the
person. Cool the material with water
Brush off dry chemicals (protect yourself!); Irrigate
chemical burns with cool (not cold) water for at
least 30 minutes; Cover wounds with clean dry
sterile dressings in hospital, clean sheets or towels
at home; Clean wounds gently with sterile saline if
available; Apply NO creams, ointments or ice;
Check circulation frequently for compartment
syndrome

Airway and respiratory concerns and complications Systemic response > pulmonary edema, resp.
w/ burns
insufficiency & failure; Increased vascular
resistance d/t vasoconstriction in pulm capillaries
> pulm edema; Decreases pulm perfusion & O2
diffusion; Circumferential chest burn > inability to
expand chest > resp distress & hypoxemia;
Inhalation injury > resp failure & ARDS; Leading
Cause of Death in Fire Victims
What assessment findings would cause you to be
concerned about the airway w/ a burn pt.?

Flail/ T.Pneumo/ Hemothorax present; ARDS

(signs & sx); soot around mouth; Hoarseness,
Stridor; S & Sx of hypoxia: Pallor, cyanotic,
increased HR, increased RR, decreased O2 sat

How long is the airway at risk for a burn pt?

48 72 hours post burn

What emergency treatment will you need to

request for an inhalation burn pt?

Requires immediate intubation & mechanical

ventilation with PEEP (keeps alveoli open so they
dont collapse); High risk of airway obstruction;
PaO2 < 60 intubate

Lab abnormalities in burn patients

H & H elevated (hemoconcentration) looks higher

than it actually is; Na+ Decreased (moves to
interstitial spaces); K+ Elevated (damaged cells);
pH low (metabolic acidosis)

How do you protect grafted tissues?

Provide wound coverage until autograft possible;

Maintains moist environment; Can test readiness
for autografting

What supplies would you need for wound care?

Protective barriers (mask, cap, gowns, gloves);

Sterile scissors and forceps; topical antimicrobial

In what direction should a dressing for a burn go?

Circumferential dressing distal to proximal; Digits

wrapped individually

When is Silvadene contraindicated?; Why is it

used for burn patients?

Sulfa allergy; bc it helps prevent infection

How would you manage pain before a dressing

change?

Provide pre-medication for pain; let them watch tv

while dressing it being changed

Parkland formula for fluid resuscitation

TBSA burned(%) x Wt (kg) x 4mL

Give 1/2 of total requirements in 1st 8 hours, then
give 2nd half over next 16 hours.

Why are fluids needed?

To prevent burn shock

Systemic Response to Burns

The initial systemic event after a major burn injury

is hemodynamic instability, resulting from loss of
capillary integrity leading to shift of fluid, sodium,
and protein from IV space into interstitial space;
this leads to HYPOVOLEMIA!

Peripheral Vascular Effects of burns

Leaky capillaries = massive tissue edema >

Compartment Syndrome; Thrombus formation &
vasospasm, esp. w/ electrical burns

Vascular Effects of Burns

Loss of capillary seal = leaky capillaries d/t SIRS;

Massive fluid & electrolyte shifts occur: Greatest
changes occur 18-36 hrs after injury, May continue
for 2 weeks; Burn size impacts fluid shift

GI and Metabolic Effects from burns

GI problems = paralytic ileus (no movement),

Curlings ulcer (stress ulcer associated with severe
burns), GI permeability; Cannot absorb nutrients
essential for healing; Peritonitis occurs

Renal Impact of Burns

Oliguria & anuria d/t fluid shifts & hypovolemia;

Renal failure d/t: Hypovolemic shock>SIRS
>MODS; Hemoglobinuria from RBC destruction;
Myoglobinuria from muscle damage (turns urine
reddish-brown; blocks renal tubules)

Targets for urine output post burn; What type of

acute renal failure(s) is likely to occur

Adult: 30-50ml/hr; if myoglobinuria 75 to

100ml/hr; pre-renal or intra-renal

Metabolic function

Initially depressed, then hypermetabolic state

follows; Depressed when capillary permeability is
high; Capillary seal restored @ approx. 36 hrs &
then BMR rises dramatically; Hypermetabolic state
lasts until wounds closed / healed; Increases
HR/RR/C.O., O2, body temp, & caloric needs

What two medication routes are NOT used for a pt

who has sustained burn injuries?

IM and SQ

Amount of calories needed to prevent weight loss

from burn

> 10% body weight May be > 5000 cals / day!,

also need high protein to maintain positive nitrogen
balance

Nutritional support for burn patients

High-calorie, high-protein diet, includes fat and

vitamins; Vitamin C for collagen synthesis, immune
function; Vitamin A for immune function,
epithelization; Enteral Feeding begins within hours
of admission tube placed within 4-12 hrs; Tube
feedings may be used to supplement oral intake;
TPN only used if ileus / GI permeability occurs

When a burn pt is able to start eating again, what

are they allowed to have?

Just about anything, as long as its high cal/high

protein

3 Phases of Burn Injury: Emergency or

Resuscitation Phase; Acute Phase; Rehabilitative
Phase

From onset of injury up to 36-48 hours after injury;

48-72 hours after time of injury; From wound
closure to discharge and beyond

Acute Phase

Continued airway/respiratory dangers; Capillaries

regain integrity diuresis; Fever is common (bc of
increased metabolism); Infection progressing to
septic shock major cause of death in those that
have survived first few days; Infection control,
Enteral feeding once GI integrity returns

Hydrotherapy & showering

Water temp 100 F; Room temp 80 85 F; 20 30

minutes; Exercise extremities

Autografts

Preferred method for burn wound closure; Caution

with position and turning to reduce risk of graft
dislodging no pressure to area; Extremityelevate, immobilize: Exercise allowed in 5 7
days; Donor site partial thickness: Keep clean,
dry and free from pressure, Very painful

How should a patients protect their skin from the

sun?

Lubricate with mild lotion, no scented products

What different organs can pancreatitis affect?

Lung, liver, stomach, kidney, colon

Pseudocysts

accumulations of fluid and tissue debris.

Assessment findings in pancreatitis? Which

assessments indicate more severe problems?
What are the 3 main causes of pancretitis?

Intractable nausea and vomiting, Abdominal pain

and distension (a lot of pain), Fever; Systemic
complications ARDS, shock, acute renal failure,
DIC

What are the main causes of death during the first

2 weeks with pancreatitis?

ARDS and Renal failure

What are the 3 main causes of pancretitis?

Excessive alcohol consumption; Acute / chronic

cholelithiasis: gallstones obstruct the common bile
duct; Elevated Triglycerides: Levels above 1000
mg/dl occlude capillaries in the pancreas.

Pancrease (pancreatic enzymes). What major

nutrient do these assist a patient with pancreatitis
to digest? What is the major sign that your patient
may need a higher dose of these enzymes?

Fat; If the stool is smelly, oily, and loose

Risk factors for hepatitis A, B, and C; What lab

tests are done to test for hepatitis?

Poor hygiene???; Hepatitis panal, screens for hep

Antibodies (A, B, +C).

Expected labs from hepatitis

Low Hgb, Hct, Albumin; Leukocytosis, Elevated

bilirubin, ALT, AST, GGT, Ammonia; Liver biospy
shows fatty infiltration of liver; Liver must be 70 %
damaged before labs for liver function appear
abnormal.

Hepatitis panal, screens for

Hep antibodies

How is Hep A transmitted?

Fecal Oral Transmission; Contaminated food

and water.

How are Hep B and C transmitted?

Contaminated blood products; Needle sticks /

contaminated needles; Sexual contact; During
childbirth

Risk factors for non-infectious forms of hepatitis?

On a lot of meds for a long time or excessive

alcohol intake

Which commonly used meds have a potential side

effect of liver damage besides Tylenol?

Some antibiotics; Anesthetic drugs; Satin drugs;

Psych drugs; Seizure meds

Three assessment findings that separate hepatitis

from cirrhosis

Fever, malaise, RUQ tenderness

Key lab abnormalities in a patient with liver

disease?

Increased AST and ALT

Why do you need to be careful with any med

administration in patients with liver disease?
Hepatic diet

Small meals, low sodium, high carb, moderate fat,

low protein,

Assessment findings in a patient with peritonitis?

Severe systemic effects, septic shock; Rigid,

board-like abdomen; Difficulty breathing due to
pain; Rapid, shallow respirations; Fever and chills;
Nausea and vomiting; Loss of appetite; WBC
extremely elevated; Shallow respirations r/t
abdominal distention; Abdominal guarding, worse
with movement; Fluid or air trapped in the bowel;
Inability to pass gas or feces

Expected assessment findings and interventions

post-op for a patient with peritonitis?

Wound packed and left open or drains in place;

Risk for sepsis (happens quickly), ARDS, shock;
Long term risk of adhesions (could twist around
the bowl and cause a bowel obstruction)

Grey Turners sign; Cullens sign

Blue discoloration of the flanks; Blue discoloration

in the umbilical area

Key lab abnormalities in a patient with

pancreatitis?

Serum amylase >200 and Serum lipase 2-3x the

norm

What are the signs / symptoms of increased

bilirubin in a patient with liver disease?

Yellowed skin, sclera, and / or mucous

membranes; Urine dark due to bilirubin in urine;
Stools pale or grayish due to absence of bilirubin
in stool.

What is the relationship between Tylenol and liver

disease?

Acetaminophen is hepatotoxic

Why do you have to be concerned about bleeding

in a patient with liver disease?

Because they have low Hct and Hgb????

Why do you need to be careful with any med

administration in patients with liver disease?

???

Lactulose. Why is it used in liver disease? What

assessment findings tell you it is working? What
side effect tells you it is working?

Pulls ammonia out through the GI tract; Improved

mental status; Diarrhea

Assessment findings in a patient with bleeding

esophageal varices?

Vomiting bright red blood (hematemesis Upper

GI); Black tarry stools (Lower GI); Bright red
bleeding from the rectum d/t Hypermotility of
bowel and Rectal varices

What types of foods would cause problems with

varices?

Spicy and acidic foods

What are the most dangerous risks of ulcers?

How should the nurse manage these problems
when they occur?

Perforation: ulceration through wall of stomach

Hemorrhage: ulceration into a major vessel in the
stomach

How should the nurse manage problems with

ulcers when they occur?

Prevent aspiration and Monitor position of balloon

(never reinsert balloon)

Nursing and medical interventions related to

bleeding varices?

Blood products-PRBC and plasma; Sandostatin

(octreotide): Decreases vasodilation
(Vasopressors rarely used because of risks from
vasoconstriction); Gastric Lavage - removes blood
from the GI tract to enhance visualization

Emergency interventions related to varices and

treatments for varices?

Balloon tamponade - collapses varices with

pressure > decreases bleeding.

When are acid suppressing meds used for patients Post op to prevent re-bleed.
who do not have ulcers?
What meds put the patient at increased risk for
ulcers?

NSAIDS (ibuprofen, naproxen, toradol),

anticoagulants, Corticosteriods

Which foods may cause pain for a patient with

peptic ulcer disease?

Pickled foods, Spicy foods, Salted foods,

Processed foods, Alcohol, Tobacco, Acidic foods,
Greasy foods

Criteria for preforming surgery on an ulcer

More than 8 units of blood in 24 hrs.

What assessment can you perform to see if nasal / Halo sign; the leaking fluid is dripped onto a 4x4
ear drainage is spinal fluid? How do you perform
gauze or towel.
this assessment?
Priority interventions for head and spinal injuries?

Prevent further damage (keep immobilized) and

maintain an airway

Steroids. Why are they used in spinal injuries?

Which steroids can you expect to see ordered?
What routes will be used to administer these
steroids?

To decrease inflammation; solu-medrol; IV dilution

Expected assessment findings in a patient

immediately after spinal injury?

Hypotension and bradycardia

Possible complications in a patient who is

paralyzed due to a spinal injury in the past.

Loss of temperature control due to inability to

vasoconstrict, reflexes can be atypical, Respiratory
Insufficiency (C1-C4 injuries), painful muscle
spasms,

Which head injury / bleed is most closely related to Closed (Blunt Trauma)
falls?
Which injury / bleed is most closely related to
hypertension / ruptured aneurysm?

Intracerebral Hemorrhage

What are the three vital sign characteristics

included Cushings triad?

Systolic Hypertension w/ a widened pulse

pressure; Bradycardia; Cheyne-Stokes Respiratory
Pattern / Hyperventialation

How do Decerebrate and Decorticate affect the

Glascow Coma Scale?

Decerebrate is and extension to pain earning 2

points, while Decorticate is abnormal flexion to
pain earning 3 points

What does Decerebrate and Decorticate tell you

about your patients brain injury?

Decorticate: Caused by damage to the cerebrum

and / or midbrain, GCS of 3 in the motor section;
Decerebrate: Indicates severe injuries to the
midbrain and / or cerebellum, Poor prognosis for
patient, GCS of 2 in the motor section

Major risks of intracranial pressure monitoring.

Infection in the brain bc of the burr holes

Earliest sign of increased intracranial pressure that Declining LOC

the nurse can easily assess?
Nursing interventions to decrease the risk of
increased intracranial pressure?

Manage MAP w/ IV fluids to maintain CPP > 70;

ICP Monitoring: needs to be below 20-25 mmHg;
Elevate HOB 30 degrees Decrease agitation and
restlessness: Minimize use of restraints;
Neuromuscular Blocking agents (occasionally
used to keep patient still); SAP protocol: Sedation,
analgesic, paralytic

Why is the risk of DVT / PE higher in patients who

have aneurysms or other types of brain bleeds?

Because they are on bed rest and do NOT give

blood thinners

What assessment finding should alert the nurse to

the possibility of bleeding or herniation in the
brain?

Dilated pupil on the same side as the injury

Spinal shock. What is it? What are assessment

findings that indicate that it is resolving?

Immediate response to cord transection /

injury; Hypotension due to dilation of vessels r/t
paralysis; Bradycardia due to vagal nerve activity
& decreased sympathetic nervous system
response; 1-6 weeks long in temporary injuries;
When reflexes return, it means this problem is
resolving

Guillain-Barre syndrome. What in the patients

history would lead you to suspect this syndrome?

Recent infections: Influenza, Campylobacter jejuni

CMV

What is the progression of this Guillain-Barre

syndrome?

Paralysis that moves from the lower legs up.

What can you expect as your patient gets worse

and then better?

???

With regards to chemical burns what do acids

produce and Alkalis cause what?

Coagulation necrosis-eschar; liquefaction necrosis

(liquefy tissue - penetrate deeply)

Zones of Damage: Center; Stasis; Hyperemic

Coagulation - Non-viable tissue (never coming

back); Slowed blood flow in capillaries and small
vessels - Viable tissue, can convert to non-viable;
Area of increased blood flow (good chance of
getting better), Superficial damage, Will heal
quickly

Zones of Damage

A burn that is 25% or more of TBSA involved will

cause what?

Systemic response proportional to the extent of the

injury

Face, neck, chest burns

Associated with pulmonary damage and inhalation

injury. Assess airway and breathing.

Facial burns

Corneal abrasions. Assess eyes.

Circumferential thorax burns

Diminished chest expansion might need an

Escharotomy

Circumferential extremity burns

Distal vascular insufficiency. Assess circulation to

extremities.

3 Phases of Burn Injury

Emergency or Resuscitation Phase: From onset of

injury up to 36-48 hours after injury; Acute
Phase:48-72 hours after time of injury;
Rehabilitative Phase: From wound closure to
discharge and beyond

All inhalation injuries could lead to what?

ARDS