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Burn: Respiratory System and 18-year-old Female College

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Case Study 2: Burns

Situation: You are working the day shift on the medical-surgical unit in a small district hospital. Your assignment includes an 18-year-old female college student, admitted the previous night. She was caught in a house fire and sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back.

1. The client is undergoing burn fluid resuscitation using the standard Baxter (Parkland) formula. She was burned at 0200 and admitted at 0400. She weighs 110 pounds. Calculate her fluid requirements, specify the fluids used in the Baxter formula, specify how much will be given, and indicate what time intervals will be used.

Baxter Formula: Lactated ringer's 4 ml/kg/%burn/24 hours - …show more content…

• Eyes: Eyes may be red and irritated by the smoke, and there may be burns on the corneas in the eyes. • Skin color: Skin color may range from pale to bluish to cherry red. • Soot ➢ Soot in the nostrils or throat may give a clue as to the degree of smoke inhalation. ➢ The nostrils and nasal passages may be swollen.

• Headache ➢ In all fires, people are exposed to various quantities of carbon monoxide. ➢ The patient may have no respiratory problems, but may still have inhaled carbon monoxide. ➢ Headache, nausea, and vomiting are symptoms of carbon monoxide poisoning.

• Changes in mental status ➢ Chemical asphyxiants and low levels of oxygen can lead to mental status changes. ➢ Confusion, fainting, seizures, and coma are all potential complications following smoke inhalation.

3. The client is concerned about visible scars. What will you tell her to allay her fears?

I would inform the patient that most skin burns that are small and superficial will heal within one week and will not usually scar. After a superficial partial-thickness burn, the skin may become darker or lighter in color, but will not usually scar.

4. The client is in severe pain. What is the drug of choice for pain relief following burn injury, and how should it be given?

Morphine Sulfate or Meperidine (Demerol) through

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