Question

Chapter 24 Burns Initial Management of a Patient with Burns Approx 60 min Name:                              &

Chapter 24 Burns

Initial Management of a Patient with Burns

Approx 60 min

Name:                                                                         Date:

Patient Profile

M.J. is a 63-year-old white woman transferred via ambulance to the hospital after a fire in her apartment. She was asleep when the fire started and managed to make her way out of the apartment through the smoke. She sustained second- and third-degree burns over the right side of her face and neck, right side of the anterior trunk, two thirds of the lower right thigh, and the right arm. In the emergency department, she received a tetanus shot, morphine for pain, and 2 L of IV fluids.

Subjective Data

  • Single; lives alone
  • Works full-time as a server
  • Denies tobacco, alcohol, and drug use
  • History: CAD, CHF

Objective Data

Physical Examination

  • Blood pressure 190/80, pulse 88, temperature 99°F, respirations 28
  • Height 5'4", weight 180 lb
  • Voice is hoarse; singed nose hair
  • Productive cough with moderate amounts of gray sputum
  • Pupils equal, round, reactive to light and accommodation; right eye swollen
  • Heart rate and rhythm regular; no murmur
  • Lungs with wheezes throughout
  • Bowel sounds diminished in all four quadrants
  • Restless, states pain is at a level 10 on 10-point-scale
  • Urinary catheter draining burgundy-colored urine
  • Nasogastric tube is draining yellow-green drainage

Burns Case Study Questions for Week 6

  1. During the initial fluid resuscitation for M.J.’s burns, lactated ringers was the fluid of choice to be infused. Why would the nurse choose lactated ringers as the preferred fluid of administration?

Answer:

  1. What are three potential complications that M.J. might experience relating to her sustained second-and-third degree burns to her face, neck, trunk, right lower thigh, and right arm? Student are to list at least three:

1.

2.

3.

  1. Explain the significance of M.J’s vital signs: Student Must Address all:

Temp:

Pulse:

BP:

RR:

  1. What would you as a nurse assess in a burn patient for an inhalation injury? Student must list at least five:

1.

2.

3.

4.

5.

  1. What are at least three questions to ask the patient or relative during your assessment?

1.

2.

3.

  1. What would concern you in this patient’s medical history in giving IV fluids?

Student must list at least two:

1.

2.

           

  1. Explain the rule of nines in reference to M.J.’s burned areas.

Answer:

  1. Explain what medications will probably be administered to M.J. (Think about the holistic aspects of the scenario), including, why, and one or two side effects that you, the nurse should monitor. Student must list at least two:

1.

2.

  1. Who are other disciplines to consider in helping to manage the burn patient, based on the presentation of the case? Student must list at least seven:

1.

2.

3.

4.

5.

6.

7.

  1. What would be your three prioritized nursing diagnoses for M.J., include r/t and aeb where appropriate? One risk is acceptable. Student must list at least three:

1.

2.

3.

Reference(s):

Harding, M. M., Kwong, J., Roberts, D., Hagler, D., and Reinisch, C. (2020). Lewis’s

     Medical-Surgical Nursing: Assessment and Management of Clinical Problems (11th Edition),

     St. Louis Missouri: Elsevier.

           

           

Homework Answers

Answer #1

Answers-*LACTATED RINGER SOLUTION IS HELPED TO RAPID RESTORATION OF CIRCULATING BLOOD VOLUME OR FLUID BALANCE AFTER BURNS. *THREE POTENTIAL COMPLICATIONS OF BURNS IN THIS PATIENT1)PNEUMONIA 2) PAIN 3) RESPIRATORY ARREST *TEMPERATURE-99DEGREE F, SHOWS NORMAL -PULSE-88 b/mt-It is a Normal Heart Rate. -Respiration-28/mt shows Tachypnoea due to inhalation Injury of Lung tissue _Blood pressure-190/80 shows Hypertension related to CHF. *INHALATION INJURY ASSESSMENT 1) FACIAL BURNS 2) HOARSNESS OF VOICE 3) TACHYPNOEA 4) WHEEZING LUNG SOUNDS 5) SINGED NASAL HAIR

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