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Terms in this set (131)

when open burns wounds are exposed, staff should wear: disposable hats, masks, gowns, gloves
room should be kept warm - 85 degree F
shower - tap water not exceeding 104 F is acceptable; once daily; surgical detergent, disinfectant, or cleaning agent may be used
debridement - if extent, will take to OR
drug therapy
antimicrobial agents - suplha drugs, worry about allergies; topical agents (silver sulfadiazine; mafenide acetate); systemic agents not usually used in controlling burn flora (initiated when diagnosis of invasive burn wound sepsis is made) - in sepsis, will see fever, fatigue, BP decreased, changes in WBC bands; look at wound & if its purulent, dirty & then you would start systemic antibiotics
hands & arms should be extended & elevated on pillows or slings
ears should be kept free of pressure - head hang a little over bed without a pillow
early ROM exercises
perineum must be kept as clean and dry as possible - will have catheter for a little while; watch for catheter associated UTIs
drug therapy - analgesics & sedatives (morphine, hydromorphone (dilaudid); haloperidol (haldol); lorazepam (ativan); midazolam (versed)); best route - IV push; won't have bowel sounds so can't do PO
may add sedative or antianxiety drug to help w/ pain; tetaum immunization (given routinely to all burn patients); VTE prophylaxis (low molecular weight heparin or low dose unfractionated heparin is started; those at high bleeding risk, with mechanical VTE prophylaxis with sequential compression devices
facial care - performed by the open method; lay 4x4 on top of face, do not occlude; do not wrap face; highly vascular & is subject to a great amount of edema
eye care for corneal burns - antibiotic ointment is used; periorbital edema may frighten patient
nutritional therapy - fluid replacement takes priority over nutritional needs; early & aggressive nutritional support within hours of burn injury (decreases mortality & complications; optimizes wound healing; minimizes negative effects); early, continuous enteral feeding or parenteral feeding promotes optimal conditions for wound healing & decreased mortality (may have PEG or NG tube; if don't have bowel sounds start w/ TPN); supplemental vitamins & iron may be given; monitor BUN, albumin, creatinine (adequate nutrition proteins, renal function)
hypermetabolic state - resting metabolic expenditure may be increased by 50% to 100% above normal; core temperature is elevated; caloric needs are about 5000 kcal/day; often have adynamic ileus which is like paralytic ileus; risk for curling's ulcer (acid/stress ulcer; give nexium or H2 inhibitors to prevent)