Burns and Dermatologic Disorders - Concept Map
Integumentary System Injury and Disease Management
Related concepts
Burns
Sub concepts
- Classification by Depth
- TBSA Estimation
- Pathophysiology
- Fluid Resuscitation
- Clinical Phases
- Complications
- Pharmacology
Relationship to central
Acute traumatic injury to integumentary system requiring emergency assessment and multi-phase management
Dermatologic Disorders
Sub concepts
- Inflammatory Disorders
- Infectious Disorders
- Assessment and Management
- Psychosocial Considerations
Relationship to central
Chronic or acute non-traumatic skin conditions requiring therapeutic management and patient education
Nursing Process Application
Sub concepts
- Assessment Techniques
- Nursing Diagnoses
- Priority Setting
- Interventions
- Evaluation
Relationship to central
Systematic approach to assessment, diagnosis, planning, implementation, and evaluation using NANDA taxonomy
Concept connections
- Burn Depth ClassificationTBSA EstimationOnly partial-thickness and full-thickness burns (second-degree and deeper) are counted toward TBSA; superficial first-degree burns are excluded from calculations
- TBSA EstimationParkland FormulaTBSA percentage is a critical variable in the Parkland formula calculation: 4 mL × kg × %TBSA = total fluid for 24 hours
- Parkland FormulaFluid Resuscitation MonitoringThe formula provides initial fluid volume, but urine output (0.5 mL/kg/hr in adults) is the primary indicator guiding titration and adequacy assessment
- Emergent Phase PathophysiologyHyperkalemiaCellular destruction and massive fluid shifts release potassium into the intravascular space, causing life-threatening hyperkalemia requiring cardiac monitoring
- Acute Phase PathophysiologyHypokalemiaAs fluid shifts reverse and diuresis begins, potassium re-enters cells and is lost in urine, shifting the electrolyte balance from hyper- to hypokalemia
- Infection RiskAcute PhaseInfection and sepsis become the primary threat during the acute phase as the immune response is impaired and the wound becomes colonized with bacteria
- ContracturesRehabilitation PhaseContractures are the most common late complication of burns and develop despite early intervention; prevention requires positioning, splinting, and continuous ROM exercise
- PsoriasisAutoimmune PathologyPsoriasis is a chronic autoimmune disorder of accelerated epidermal cell turnover resulting in characteristic silvery plaques on extensor surfaces
- DermatitisInflammatory ResponseDermatitis represents an acute or chronic inflammatory response to irritants or allergens, manageable but not curative
- CellulitisBacterial InfectionCellulitis is an acute bacterial infection of the dermis and subcutaneous tissue requiring systemic antibiotics and requiring infection control monitoring
- Inhalation InjuryAirway PriorityInhalation injury is the leading cause of early death in burn victims and requires immediate airway assessment and 100% humidified oxygen
- Electrical BurnsMyoglobinuriaElectrical burns cause deep tissue damage leading to rhabdomyolysis, myoglobinuria (dark urine), and risk of acute kidney injury requiring aggressive fluid resuscitation
- Curling UlcerStress ResponseCurling ulcer (stress-related gastric ulcer) is a common complication requiring prophylactic proton pump inhibitors or H2 blockers during acute phase
- Burn DepthPain LevelSuperficial partial-thickness burns are the most painful (intact nerve endings); full-thickness burns are painless (nerves destroyed); deep partial-thickness burns have intermediate pain
- Wound ClosureRehabilitation Phase InitiationThe rehabilitation phase begins once wound closure is achieved, shifting focus from resuscitation and infection prevention to function restoration and appearance
- Silver SulfadiazineTopical AntimicrobialSilver sulfadiazine is a broad-spectrum topical agent commonly used for burn wounds; contraindicated in sulfa allergy and requires monitoring for transient leukopenia
- Mafenide AcetateEschar PenetrationMafenide acetate penetrates eschar effectively, useful over cartilage, but causes painful application and metabolic acidosis through carbonic anhydrase inhibition
- NANDA Nursing DiagnosesMaslow PrioritizationNursing diagnoses are organized using Maslow's hierarchy: physiological needs (airway, fluid, pain) take priority over safety, belonging, esteem, and self-actualization
- AssessmentNursing DiagnosisComprehensive assessment guides selection of appropriate NANDA nursing diagnoses, which form the basis for planned interventions and patient outcomes
- RA 9173Nursing Practice StandardsThe Nursing Law (RA 9173) defines the scope and competencies expected of Filipino nurses, including assessment, intervention, patient education, and documentation in burn and dermatologic care
Diagrams
Burns and Dermatologic Disorders - Comprehensive Concept Map
Comprehensive mind map showing the hierarchical organization of Burns and Dermatologic Disorders. The central concept branches into three main areas: Burns (with depth classification, TBSA estimation, pathophysiology, fluid resuscitation, clinical phases, complications, and pharmacology), Dermatologic Disorders (inflammatory, infectious, assessment/management approaches), and Nursing Process Application (NANDA diagnoses, assessment priorities, Maslow-based prioritization, and RA 9173 competencies). This map integrates clinical knowledge with Philippine nursing practice standards required for NLE success.
Burn Assessment and Initial Management Algorithm
Step-by-step flowchart for initial burn assessment and management following the emergency nursing protocol. Begins with identification of inhalation injury risk, progresses through airway management, fluid resuscitation using the Parkland formula, and continuous monitoring of urine output. Includes decision points for TBSA calculation, circumferential burn assessment, and preparation for escharotomy. This algorithm reflects the priorities emphasized in the NLE examination: airway first, then fluid resuscitation guided by urine output.
Three Phases of Burn Management and Complication Risk
Comprehensive flowchart depicting the three distinct phases of burn management with their unique pathophysiology, electrolyte patterns, clinical threats, key interventions, and complications. The Emergent Phase emphasizes hypovolemic shock prevention through Parkland resuscitation and hyperkalemia monitoring. The Acute Phase highlights infection/sepsis risk, hypokalemia development, and intensive wound care. The Rehabilitation Phase focuses on contracture prevention and scar management as the most common late complication. This visual representation helps learners understand why nursing priorities shift across phases and what to monitor at each stage.
Parkland Formula Calculation and Implementation
Detailed flowchart of the Parkland formula with worked example showing calculation steps, solution selection, critical timing, monitoring parameters, and titration based on urine output. This is one of the highest-yield topics on the NLE. The chart emphasizes that while the formula provides the initial guideline, urine output is the actual goal and guide for adjusting the infusion rate. Includes a critical reminder about calculating from time of injury, not time of IV insertion—a common exam question.
Burn Depth Classification and Clinical Features
Comprehensive flowchart showing the five burn depth classifications from superficial first-degree through fourth-degree burns. Each classification is broken down by depth of injury, clinical appearance (color, moisture, texture), special features (pain level, blanching, capillary refill), and healing characteristics. This chart emphasizes critical differentiators for NLE exam success: superficial burns are painless with blisters in partial-thickness burns, full-thickness burns are painless and leathery, and only second-degree and deeper burns are counted in TBSA calculations. Color-coded for visual distinction.
Dermatologic Disorder Assessment and Management Algorithm
Comprehensive assessment and management flowchart for common dermatologic disorders encountered in clinical practice and on the NLE. Begins with focused history and visual assessment, progresses through differential diagnosis based on key clinical features (distribution, appearance, borders, symptoms), and branches to disorder-specific management including medications, nursing interventions, and patient education. Includes color-coding for quick visual reference and emphasizes critical nursing actions like marking cellulitis borders, completing antibiotic courses, and recognizing red flags for complications.
Rule of Nines: Adult TBSA Distribution
Pie chart visualization of the Rule of Nines for adult body surface area (TBSA) distribution. Each major body region is shown as a percentage, with most areas representing 9% (multiples of 9%) and the perineum at 1%, totaling 100%. This visual aid helps learners quickly recall the proportions needed for TBSA calculation in burn patients. The Rule of Nines is essential for determining fluid resuscitation requirements using the Parkland formula and for severity classification of burn injuries.