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Nurse Practitioner:
doi: 10.1097/01.NPR.0000387099.02066.07
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Treatment of the burn patient in primary care

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INSTRUCTIONS Treatment of the burn patient in primary care

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Treatment of the burn patient in primary care

General Purpose: To provide the NP with an overview of assessment and treatment of the burn patient in primary care. Learning Objectives: After reading the preceding article and taking the following test, you should be able to: 1. Discuss the pathophysiology of burns and the assessment of the burn patient. 2. Describe care of a burn injury during the acute and rehabilitative stages.

1. Infants and children are more likely than adults to experience

a. more severe burns due to a thicker dermis.

b. less evaporative loss from burn wounds.

c. superficial burn wounds.

d. hypothermia secondary to burn wounds.

2. Which would be defined as a "minor burn" by the American Burn Association?

a. second-degree burns less than 25% of Total Body Surface Area (TBSA) in people 30 to 50 years old.

b. first degree burns over 15% of TBSA in children and adults less than 50 years old.

c. second-degree burns less than 10% TBSA in children under 10 and adults over 50 years old.

d. third-degree burns less than 12% TBSA in all populations.

3. The depth of a burn wound depends on the

a. temperature and duration of contact with the injuring agent.

b. pigmentation of the skin.

c. tone and elasticity of the skin.

d. effectiveness in cooling the burned skin.

4. Superficial second-degree burn wounds

a. involve only the epidermis.

b. usually heal with minimal scarring within 2 weeks.

c. are insensate due to destruction of sensory nerve endings.

d. are pale and dry.

5. Deep second-degree burns

a. involve all of the epidermis and all of the dermis.

b. are more painful than superficial second-degree burns.

c. frequently heal in 2–4 weeks.

d. often heal without significant scarring.

6. Which characteristic is not typical of a large 3rd degree burn injury?

a. It is insensate.

b. It does not heal spontaneously.

c. It involves all of the dermis.

d. It extends into muscle and tendons.

7. The "Rule of Nines"

a. divides the adult body into anatomic regions of 9% or a multiple of 9%.

b. divides the body into 9 anatomic regions.

c. works well in all burn cases.

d. is modified for infants by decreasing the head size from 18% to 14%.

8. Which patient should be referred to a burn unit?

a. a 10% TBSA partial thickness burn

b. a toddler with a 5% TBSA second-degree burn

c. a teenager with an electrical burn

d. an older adult with a 1st degree burn from suspected abuse

9. Burn pain

a. during dressing changes is usually well controlled by NSAIDS.

b. relieved by debridement.

c. is most painful in superficial partial thickness burns.

d. is uncommon in most burns.

10. Research has demonstrated that intact burn wound blisters

a. depress immune function due to the fluid in the blister.

b. cause increased pain during dressing changes.

c. inhibit local inflammation.

d. should never be debrided.

11. Shaving hair associated with a burn wound

a. increases the pain of subsequent wound care.

b. increases the risk of infection.

c. makes it easier to evaluate the wound.

d. makes devitalized tissue and exudates more difficult to wash off.

12. In the primary care setting, superficial second-degree burn wound infection is best prevented by

a. using topical antimicrobials.

b. prescribing systemic antibiotics.

c. routine culturing.

d. covering burns with an occlusive dressing.

13. Which treatment is the most economical and appropriate choice for a superficial partial thickness burns without adherent exudate?

a. enzymatic debrider covered by a non-adherent dressing

b. bacitracin ointment covered by an occlusive dressing

c. bacitracin ointment covered by a non-adherent dressing

d. silver sulfadiazine 1% covered with a non-adherent dressing

14. Which instruction is not appropriate for a patient with facial burns?

a. Wash area at least twice a day.

b. Apply a thick coating of bacitracin ointment and a light dressing.

c. Keep the wound moist.

d. Increase intake of high protein and caloric fluids.

15. Which treatment may be used for deep partial thickness burns when surgery is not an option?

a. enzymatic debrider

b. silver sulfadiazine 1%

c. alginates

d. hydrofibers

16. Which common complaint during the rehabilitative phase of burns is particularly hard to treat?

a. pain with exercise

b. pain due to pressure and positioning

c. sleep disturbances

d. itching

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