Question

Initial Management of a Patient with Burns (Q: 5, 6, 7)

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 pain is at a level 10 on 10-point-scale
• Urinary catheter draining burgundy-colored urine
• Nasogastric tube is draining yellow-green drainage

Discussion Questions

5) The nurse is concerned about smoke inhalation. What assessment findings would support her concerns?

6) M.J.’s pain level is a 10. Outline a pain management plan for M.J. at this time.

7) Describe other nursing and interprofessional management that is important during this phase.

Answer 1

5,

Smoke inhalation is a dangerous condition which occurs due to the inhalation of harmful gases or particles this cause serious effects on the lungs and decrease the oxygen intake. This will affect the entire body then.

Due to this patient is get out off the apartment through smoke patient may inhale the harmful gases. From the objective data is is seems that productive cough present and the sputum is in gray color. The on auscultation wheezing present. Those concerns about smoke inhalation.

6.

Pain management interventions include:

Administer morphine or other analgesics to reduce pain.

Use diversional therapies

Provide a clam and quiet environment and promot sleep

Provide psychological support to the patient.

Provide comfort devices to patient.

7,

Important management during acute stage of burns include:

Administer fluids to correct the fluid imbalance

Assess the burns percentage and pain level of patient

Clean the burned wounds and if needed debrainment surgery can be done

Provide psychological support to patient.

Restrict the visitors and all procedures should be done under strict sterile technique