Question 1

When an individual sustains a burn to the epidermis, what factor could cause issues in the future?

Accepted Answer

The epidermis is responsible for producing new skin cells. If the ability to produce new skin cells is compromised, it could lead to issues with skin regeneration in the future.

Question 2

An OTA is working with an individual who has sustained a burn that goes into the dermis layer of the skin. What issue will this individual most likely deal with?

Accepted Answer

A burn that goes into the dermis layer of the skin will most likely result in scarring and contractures, which can lead to issues with range of motion. Embarrassment, lack of pigment, and inability to produce new skin cells may also be potential issues, but they are less likely to affect functional abilities compared to limited range of motion.

Question 3

As a client reaches full ROM, what should the OTA incorporate into the intervention to prevent the scar from adhering and to prevent deformity?

Accepted Answer

A

Question 4

A client is in the outpatient treatment phase of his burn rehabilitation. In which area can the OTA provide education to the client and his caregivers as he goes about his daily life?

Accepted Answer

The OTA can educate the client and caregivers about sun protection during outside activities to prevent further skin damage, which is crucial for burn rehabilitation.

Question 5

An OTA would like a client who has experienced a severe burn to strengthen so that he can build up endurance for future activities. What can the OTA suggest to best promote the strengthening and well-being of this client?

Accepted Answer

Encouraging mobility out of bed for all meals and activities is the best choice as it promotes strengthening and well-being by increasing physical activity and endurance. It also helps prevent bed sores and improves overall health. Providing weights for resistive activities may be too strenuous and risky for a client with severe burns, and creating an exercise program for nursing staff may not be feasible or effective. Performing all upper extremity activities in supine may help protect the healing skin, but it does not promote overall strengthening and well-being.

Question 6

A client has been prescribed pressure garments to assist with scar management. How long should these garments be worn each day?

Accepted Answer

Pressure garments for scar management should be worn for 23 hours a day to ensure continuous pressure on the scar tissue, promoting optimal healing and minimizing scar formation.

Question 7

An OTA is working with a client who sustained a severe electrical burn while at work. The client presents with skin that is slightly moist and will blanch when touched, but the capillary refill is rather slow. The individual states that he has very little pain. Which type of burn has this individual experienced?

Accepted Answer

A deep partial-thickness burn involves damage to the deeper layers of the dermis, resulting in slow capillary refill and reduced pain due to nerve damage. The skin may appear moist and blanch when touched.

Question 8

An OT practitioner is constructing an orthosis in the operating room for a client who is receiving a skin graft for a deep partial-thickness burn. What would be the valued outcome from the construction of this orthosis?

Accepted Answer

The valued outcome of constructing an orthosis in this scenario would be to position the client in an antideformity position to prevent contractures and maintain proper alignment during the healing process. This would help to preserve joint range of motion and prevent disability. While protecting the graft site and providing comfort may also be important considerations, the primary goal of the orthosis is to prevent deformity. Providing functional movement of the joint may also be important, but this is not the primary outcome of constructing the orthosis in this particular situation.

Question 9

An OTA is working with a client who sustained a superficial partial-thickness burn to her upper extremity. She is reluctant to participate in therapy due to increased pain. What should the OTA do to best meet the client's needs?

Accepted Answer

Educating the client on healing issues and joint ROM techniques can help alleviate her fear of causing more pain during therapy and encourage her participation. It can also help her understand the importance of participating in therapy to prevent complications such as contractures. Providing PROM only may not be sufficient for optimal recovery, and referring the client to the physician for pain medication may not address the root cause of the client's reluctance to participate in therapy. Creating an orthosis may not be necessary for a superficial partial-thickness burn, unless there is a need to limit joint movement for splinting or immobilization purposes.

Question 10

A client who has experienced a severe burn refuses to go back to the location where she received her burn. The client also states that she has nightmares about receiving the burn. Which psychosocial factor is the client most likely experiencing?

Accepted Answer

The client is exhibiting symptoms consistent with posttraumatic stress disorder (PTSD), including avoiding any reminders of the trauma (refusing to go back to the location where the burn occurred) and experiencing nightmares related to the event. Anger and depression may also be present as part of PTSD, but the specific symptoms presented in this scenario are more indicative of PTSD. Denial is not a likely factor, as the client is acknowledging the impact of the burn on her life.

Question 11

A client has reported that he is unable to follow the home exercise program for managing his burn. When asked why, the client states that he is rather overwhelmed by the directions. What should the OT practitioner do in response to this information?

Accepted Answer

The best response would be to adjust the complexity of the program for increased health literacy. It is important to adjust the program to the client's needs to ensure that they can successfully follow the intervention. Educating the client on the importance of the program may not address the actual problem, which is the difficulty in following the program. Using only picture-based handouts may not be effective for all clients and may limit the amount of information that can be provided. Encouraging the client to try the program again without addressing the issue of difficulty would not be helpful.

Question 12

A physician has determined that an individual's partial-thickness burn will be able to heal on its own and recommends a homograft to cover the burn and promote healing. What should the OTA be aware of when working with a client who had this procedure?

Accepted Answer

Homografts, also known as allografts, are temporary skin grafts taken from another human donor. They are used to cover large burn areas temporarily to promote healing but are eventually rejected by the recipient's immune system, as the body recognizes the graft as foreign.

Question 13

An OTA is working with a client on ROM exercises during the healing phase of the burn. The client is complaining of pain and is not moving through the full arc of motion. What technique can the OTA use to help the client increase movement?

Accepted Answer

The answer of An OTA is working with a client...

Question 14

An OT practitioner notes that a client is not carrying out her home exercise program. When asked about this, she states that her family prefers to do all of her tasks for her so that she can just rest and heal. How should the OT practitioner respond to this information?

Accepted Answer

It is important for the OT practitioner to educate the client and family/caregivers about the importance of the home exercise program and full participation in activities of daily living (ADLs) for healing and recovery. The therapist should assess and address any barriers to compliance and work with the client and family/caregivers to develop a plan that supports independence and participation in meaningful activities. Simply notifying the physician or allowing the caregivers to continue assisting the client without addressing the issue would not address the underlying problem and may hinder the client's progress towards their goals. Focusing solely on intense strengthening techniques may not be appropriate or feasible for the client's current level of function and could potentially impede their progress as well.

Question 15

An individual sustains a superficial partial-thickness burn from boiling water spilling on her arm as she was cooking. How long can she anticipate the recovery to be?

Accepted Answer

Superficial partial-thickness burns typically heal within 14 to 21 days, as they affect the outer layer of skin and part of the dermis, allowing for relatively quick recovery.

Question 16

A client had a deep partial-thickness burn to the top of her hand and arm and will be receiving a skin graft. The physician would like a graft that will not cause excess contracture because it will be placed on the hand. Which type of skin graft will she most likely be receiving?

Accepted Answer

A split-thickness sheet graft is the best choice for a hand burn because it is thinner and more pliable than a full-thickness graft, reducing the risk of excess contracture. A meshed graft may allow for more surface area coverage, but it also increases the risk of contraction. A cultured epithelial autograft is typically used for larger or more severe burns, but it may also cause excessive scarring and contracture.

Question 17

A client who has experienced a burn causing disfigurement to half of his face and amputation of his right arm feels out of place when attending social gatherings. He mentions that all of his old friends act differently toward him. The client states that he would rather just sit at home. What is the client most likely experiencing?

Accepted Answer

Social death refers to the phenomenon where an individual feels alienated or isolated from their social circles or community, often due to significant changes in their appearance or abilities that lead to perceived or actual exclusion. In this scenario, the client's disfigurement and amputation have likely led to changes in social interactions and perceptions, making him feel out of place and leading to withdrawal from social activities.

Question 18

A client is currently in the acute phase of recovery in a burn center. The client is currently not moving his hand due to experiencing intense pain. The OT practitioner has constructed an orthosis to place on his hand in the intrinsic plus position. What would be the purpose of an orthosis at this point?

Accepted Answer

The purpose of the orthosis in this case would be to prevent contractures from developing in the hand. The intrinsic plus position is a functional position that reduces tension on the flexor tendons and helps prevent shortening of the muscles and ligaments in the hand. By keeping the hand in this position, the client can avoid developing a contracture that would limit their future hand function. The other options (A, C, and D) are not the primary purpose of an orthosis in this situation.

Quiz 28: Burns Across the Continuum of Care