A patient has sustained a chemical burn from a strong alkaline agent. The emergency nurse should recognize that this type of burn is often more severe than one caused by a strong acid primarily because alkalis lead to which of the following?
Caseous necrosis, resulting in a cheese-like tissue appearance
Coagulation necrosis, which forms a protective eschar
Liquefaction necrosis, allowing for deeper tissue penetration
Fibrinoid necrosis, associated with immune-complex deposition
Alkaline substances cause liquefaction necrosis, a process where the tissue is essentially dissolved, allowing the chemical to penetrate deeper into the tissues and cause more extensive damage. In contrast, strong acids typically cause coagulation necrosis, which creates a hard, dry eschar that can limit further penetration of the acid. Caseous and fibrinoid necrosis are unrelated types of cell death associated with other pathologies like tuberculosis and immune-mediated vascular damage, respectively.
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BCEN CEN
Environment and Toxicology Emergencies, and Communicable Diseases
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