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NUR 242 Burns STUDY GUIDE

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NUR 242 • Burns Study Guide • Adil Page 1 — Brunner & Suddarth 15e Ch 57 framework NUR 242 STUDY GUIDE Burns Module 1 — Tissue Integrity / Oxygenation Reference: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th ed. (Ch 57) ★ ⚑ ◆ Yellow = blueprint | Orange = professor emphasis | Green = module objective How to Use This Guide This guide mirrors the Burns row of the NUR 242 Exam 1 blueprint and the Tissue Integrity / Oxygenation objectives in Learning Module 1. Yellow boxes flag every blueprint item; orange ★ ⚑ ◆ boxes capture the points the professor emphasized in the recorded lectures; green boxes flag the module's stated objectives. The drug and dressing chart at the end consolidates all pharmacology so you can drill the day before the exam.NUR 242 • Burns Study Guide • Adil Page 2 — Brunner & Suddarth 15e Ch 57 framework 0. Professor's Lecture Highlights Distilled from the recorded burn lectures. Read this section the morning of the exam — every callout below is something the professor said directly. 0.1 Burn Shock Has Two Mechanisms ⚑ HIGH-YIELD: Burn shock is hypovolemic + distributive — overlapping • First mechanism = HYPOVOLEMIC. Capillary leak begins seconds after the burn. Fluid shifts out of vessels into the interstitium → "third spacing." • Second mechanism = DISTRIBUTIVE. Acute lung injury and systemic mediators cause vasodilation → BP drops further. • Either way, BP drops and the patient looks like a hypovolemic shock patient. Treat with fluids first, then address vasodilation if needed. • Two complications to watch for in this chapter: DIC and ARDS. 0.2 Two Ways A Burn Patient Loses Fluid ⚑ HIGH-YIELD: "You lose fluid two ways — absolute and relative" • ABSOLUTE loss: when the skin is gone, water EVAPORATES off the wound — true loss from the body. • RELATIVE loss: capillaries become leaky → fluid shifts to interstitial space (third spacing). Water didn't leave the body but it's not in cells or vessels — "as good as gone" for cellular activity. • The patient's weight at the ER includes that third-spaced fluid, so it's NOT their dry weight — Parkland formula numbers are estimates only. 0.3 Severity Has 4 Factors ⚑ HIGH-YIELD: Memorize this 4-part list • DEPTH — how many layers of skin were burned (superficial, partial, full, deep fullthickness). • TBSA — % of body surface burned (calculated by Rule of Nines). • LOCATION — face/neck/upper chest = inhalation injury; hands/feet/perineum/major joints = functional disability + transfer to burn center. • COMORBIDITIES — very young (mostly water → evaporates → die quickly), very old (poor turgor + chronic disease), diabetics, HF, CKD all worsen prognosis. 0.4 ABA Terminology — No More "Degrees" ⚑ HIGH-YIELD: American Burn Association uses thickness, not degrees • Old: 1st / 2nd / 3rd / 4th degree. • Current: SUPERFICIAL → PARTIAL THICKNESS → FULL THICKNESS → DEEP FULL THICKNESS. • Brunner 15e Box 57-1 / Table 57-1 is the source for the descriptions. • Prof said: "I'll grab the test options both from Table 57-1 and the paragraphs that follow."NUR 242 • Burns Study Guide • Adi

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