Question

Burn Seminar Worksheet 1. Discuss the classification and types of burns and how bums are measured to determine the percentage of body surface area involved. • First Degree • Second Degree • Third Degree • Fourth Degree 2. Severe Burn Scenario: A child has been admitted to the hospital with severe burns over 30% of his body, including his face, trunk, and arms. a. What are the 5 top-priority physiological nursing diagnoses for this child, and why? 1. 2. 3. 4. 5. b. What are the top 5 priority psychosocial nursing diagnoses for this child and his family, and why? 12345.

Answer 1

1. Burns: It occurs when there's injury to the tissues of the body caused by heat, chemicals, electric current or radiation.

Classification of burns:

• Depth of burn: partial thickness skin destruction (first and second degree) and full thickness skin destruction (third and fourth degree)
• Extent of burns: Lund Browder chart, Rule of nine, Rule of palm
• Location of burns
• Patient risk factors

Types of burns:

• Thermal burns
• Chemical burns
• Smoke and inhalation injury
• Electric injury
• Cold thermal injury

Extent of burns are used to measure the total percentage of body surface area. For example, Lund Browder chart, Rule of nine and Rule of palm are used to calculate the percentage of burns

• First degree: in this type of burns percentage of TBSA (Total Body Surface Area) is not calculated as it doesn't cause a loss of skin function.
• Second degree, third degree and fourth degree burns can be measured by using either Rule of nine or Lund Browder chart.

2.a) Physiological nursing diagnosis according to priority

• Fluid volume deficit related to loss of fluid and blood: this is the priority because of fluid shift and capillary leak patient may go into hypovolemic shock
• Acute pain related to injury to the body tissues: pain can cause severity in the condition as patient may not be able to tolerate the pain and will become restless
• Imbalanced nutrition less than body requirement related to lack of food intake: it causes weakness, fatigue and may not improve the condition if nutrional requirements are not met by the body
• Self care deficit related to pain and body injury: patient may not be able to perform their daily activities and always needs assistance, support.
• Impaired sleeping pattern related to pain and discomfort: sound sleep is important for patient, due to pain patient won't be getting proper sleep which in turn deteriotes the condition

b) Psychological nursing diagnosis:

• Fear and anxiety related to disease condition and hospitalization: patient becomes anxious and has extreme fear of staying in the hospital, fear of being alone and doubts regarding treatment. So nurses or family members should provide support to the patient
• Disturbed body image related to burn injury: after patient is recovered, they may go into depression due to changes in the body image, so psychological support is important
• Deficient knowledge related to the treatment: patient has curiosity to know about their treatment as they are new in medical field. So each and every procedure or treatment should be explained priorly
• Low self esteem related to changes in the body: due to injury changes happens in the body that causes low self esteem and patient may have social isolation
• Ineffective family coping related to disease condition: patient family cannot cope with the situation, so psychological support is required by the patient and family as well.