Burns nursing care NCLEX review lecture covers burns treatment, pathophysiology, nursing interventions, degrees of burns (1st, 2nd, 3rd, and 4th degree burns with affected skin areas), circumferential burns, different causes and types of burns, and more.

What are burns? Burns occur when there is damage to the skin integrity due to some type of energy source. Burns can be caused by various sources such as:

-Heat (thermal): hot liquids, steam, fire etc. that comes into contact with the skin…most common type.
-Electrical: electric current passes through the body and damages tissues (watch for iceberg effect), heart dysrhythmias, bone fractures (cervical spine injuries) and acute tubular necrosis.
-Chemical: toxic substances come into contact with the skin (powders, gases, or certain foods).
-Cold: coldness comes into contact with the skin for too long: frostbite
-Radiation: sun, treatments for cancer
-Friction: force abrasion to the skin….car accident…road rash, rope burn

Burn severity depends on the depth of damage to the skin (burn degree), percentage of the total body surface area (rule of nines) that is burned, patient’s age, medial history, location of the burn, and did the patient experience an inhalation injury?

-1st Degree (superficial): affects the top layer of the skin “epidermis". The skin will be very red or pink, painful, warm to touch, and has no blisters. Capillary refill is brisk.
-2nd degree can be superficial or deep depending on how far the damage occurred in the dermis (partial-thickness). These burns involve the epidermis and dermis. The burn will have redness that will blanch and be shiny red/pink and moist in areas.
-3 to 4th degree (full-thickness): for these type of burns watch for eschar (hard dead tissue that can restriction blood flow and respiratory effort) and for acute tubular necrosis because myoglobin and hemoglobin can be released into circulation and go to the kidneys and block perfusion, which leads to acute kidney injury.
-3rd degree burns affect all skin layers to the subcutaneous fat (hypodermis). The burn can be yellow, red, and black. It will appear dry rather than moist/shiny. Pain sensation is gone or decreased. Skin grafting is required.
-4th degree (deep full-thickness): All skin layers are affected along with the muscle, bones, and ligaments. Burn will appear charred and black. No sensation is present.

It is important to be aware of the burns location and if the burn is a circumferential burn. This type of burn circles around an area of the body. They are most dangerous on the torso and extremities.
For nursing interventions and pathophysiology of burns please watch the video.

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