Question

You are receiving a newly admitted patient to the burn unit. Mr. Robinson is a 32-year-old male who was at work when a battery tank exploded. Mr. Robinson has sustained first, second, and third-degree burns. He has no prior medical conditions. His wife has several questions for you.

1. He has an estimated 27% TBSA affected. Discuss the pathophysiology of this type of major burn in including the cardiovascular, cellular, metabolic, immunologic, and evaporative water loss considerations you will need to take to plan his nursing care.

Answer 1

Thermal injury causes an immunosuppressed state to cause sepsis and multiple organ failure that results in microvascular dysfunction. there will be cardiac stress due to high catecholamine that causes marked tachycardia, high myocardial oxygen consumption, increased cardiac output. it needs continuous monitoring to prevent hypovolemic shock and connective cardiac failure. cellular mechanism includes zone of coagulation, stasis and hyperemia. tissues destroyed at the time of injury in the coagulation process, the zone of stasis include microvascular perfusion, burn area become necrosis with in 48 hours and area expands with depth. there will be thrombosis of vessels due to vascular damage,upregulation if inflammation medaiteros.there will be risk for enzyme tissue perfusion. hypermetaboism and catobolsim after burn causes impaired immune function that causes delay wound healing , lean body mass erosion and prevent rehabilitation effort, changes in metabolism causes hyperdynamic circulation that increase body temperature, protein catablism with wasting, lipolysis that cause fatty inflation of the liver. imparired immune function need assemene for sepsis, high protein commencement, avoiding high temperature etc. evooration of fluid cause dehydration and hypovolmic shock need continuous fluid assessment and replacement.