Question

Mr. Cinder is a 55-year old man admitted to the burn unit 48 hours ago with a diagnosis of third degree burns. He was burning leaves in his yard when his clothes caught fire. The RN is going to care for Mr. Cinder, what will he/she expect to find related to: Skin involvement, clinical manifestations, and wound appearance. What are the pathophysiological changes associated with severe burns? When Mr. Cinder enters the rehabilitative phase of his recovery what are three possible complications? For one of the complications what nursing diagnosis would you identify as a priority and why? Must contain a minimum of 250 words

Answer 1

Third-degree burns:

A burn is damage to tissues of the body caused by contact with things such as heat, radiation, or chemicals. A third-degree burn damages affects the outer layer of skin (epidermis) and the inner layer of skin (dermis).

Causes a third-degree burns

In most cases, third-degree burns are caused by:

• Very hot liquids
• Contact with a hot object
• Fire
• Electricity
• Chemicals

Symptoms of third - degree burns

Symptoms can occur a bit differently in each child. Symptoms can include skin that is:

• Dry and leathery
• Changes color to black, white, brown, or yellow
• Swollen
• Is not painful, because the nerve endings have been destroyed

Treatment:

Treatment will depend on your patient symptoms, age, and general health. It will also depend on how severe the condition is. Person usually be treated in a hospital unit that specializes in burns.

Treatment for a third-degree burn will depend on the severity of the burn. Burn severity is determined by:

• The amount of body surface that is affected
• Where the burn is located
• The depth of the burn

Treatment for a third-degree burn may include:

• Immediate care in an emergency department, possibly in a hospital burn unit
• Breathing and blood circulation support
• Intravenous (IV), given into a vein, fluids containing electrolytes
• Intravenous (IV) or oral antibiotics for infections
• Cleaning and removal of dead tissue (debridement) from the burn area
• Antibacterial cream, and other creams
• Special bandages or dressings
• Nutritional supplements and a high-protein diet
• Pain medicines
• Anti-itch medicines
• Tetanus vaccine

A large third-degree burn heals slowly. After the burn heals, surgery may be needed. This is done to improve the ability to move, and to remove and repair scarred skin.

In some cases, skin grafting may be needed to close or cover the burn. A skin graft is a piece of healthy skin from one part of the body that is removed and put on an area that needs skin. The burn area that’s covered is called the graft site. The area where a piece of skin is taken is called the donor site. After a skin graft, the donor site looks like a scrape. After a skin graft:

• A dressing is left on the graft site for a few days before it is changed. The site needs to be still and protected to begin to heal.
• The donor site usually heals in about 2 weeks.

Pathophysiology :

• The pathophysiology of the burn wound is characterized by an inflammatory reaction leading to rapid oedema formation, due to increased microvascular permeability, vasodilation and increased extravascular osmotic activity. ... Furthermore changes of the interstitial tissue after burn trauma are of great importance.

Possible complications of a third-degree burn

Possible complications can include:

• Infections that may affect any part of the body, such as the lungs
• Scarring
• Being unable to move a joint due to scarred tissue (joint contracture)
• Emotional problems
• Organ failure and death

• A contracture

Priority Nursing Diagnosis will be:

• Impaired Gas exchange
• Ineffective airway clearance
• Risk for Infection
• Fluid Volume deficit