Initial Management of a Patient with Burns
Initial Management of a Patient with Burns
Patient Profile
M.J. is a 23-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
- Attends local college part-time while working full-time as a server
- Denies tobacco, alcohol, and drug use
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 the pain is at a level 10 on 10-point-scale
- Urinary catheter draining burgundy-colored urine
- Nasogastric tube is draining yellow-green drainage
Question 1
What is the priority of care for S.N. and why?
Question 2
What is the extent of M.J.’s burn injury, and how is it determined?
Question 3
What is the stage classification of her burn injury? How do you make this determination?
Question 4
Calculate M.J.’s fluid requirements for the first 24 hours using the Parkland formula.
Question 5
The nurse is concerned about smoke inhalation. What assessment findings would support her concerns?
Question 6
M.J.’s pain level is a 10. Outline a pain management plan for M.J. at this time.
Question 7
Describe other nursing and interprofessional management that is important during this phase.
Question 8
Because of her injury, M.J. is at high risk for infection. What measures will the nurse implement to reduce the risk of infection?
Question 9
What interventions can the nurse use to address the emotional needs of a burn patient?
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