Question

The contents in this are:

Head to Toe Assessment

Empathetic conversation

Risk Factors

Nursing care

complications

Care Plan

Lab tests and rationale

Diagnostic tests and preparation

Education

Burn Assessment

Skin Assessment

Scenario:

An American Indan woman, 28 years old, staggers into the ED face is black with soot, her right arm and right leg burned, bleeding vaginally,pregnant, vomiting, bloody diarrhea, SOB,very confused, and jaundiced.

Set the scene. Use your imagination and describe this woman, her personal and medical history. You decide the conclusion of this scenario.

Answer 1

Head to toe assessment :

The woman is in a pitiful condition. Skin on the right side of her body is black and leathery,dry skin with mild swelling. changes in skin color. pain. Her eyes are yellow probably due to jaundice and vaginal bleeding. She is not very concious and is confused.

Empathetic conversation :

First would be to calm her down and let her breathe.To ensure her that the doctors and the nursing staff will do the best in their ability to save her and the child. And to not lose hope on the survival chances.

Risk factors could be :

open fire cooking, self directed or interpersonal violence, exposed heating sources or electrical cords, unsafe storage of flammable or caustic material, water heaters set above 120°F, microwave containers.

Complications

Bacterial infection, which may lead to a bloodstream infection (sepsis)

Fluid loss, including low blood volume (hypovolemia)

Extremely low body temperature (hypothermia)

Breathing problems from the intake of hot air or smoke

Scars or ridged areas caused by an overgrowth of scar tissue

Bone and joint problems, such as when scar tissue causes the shortening and tightening of skin, muscles or tendons (contractures)

Abortion or preterm delivery

Nursing care plan

Maintain proper body alignment with supports or splints, especially for burns over joints.

Perform exercises consistently, initially passive, then active.

Medicate for pain. Support the patient and family.

Burn and skin assessment

Burn could be of degrees :

First degree : They cause pain and reddening of the epidermis. They are superficial burns.

Second degree burns : affect the epidermis and the dermis . They cause pain, redness, swelling, and blistering. They are partial thickness burns.

Third degree burns: full thickness burns) go through the dermis and affect deeper tissues. They result in white or blackened, charred skin that may be numb.

Fourth-degree burns go even deeper than third-degree burns and can affect your muscles and bones.  

Diagnostic tests and preparations :

Estimation of total body surface are burnt (TBSA).

Airway. check for any blockages in your airway.

Breathing.check for signs of trouble breathing, including coughing, rasping, or wheezing.

Circulation. A provider will use devices to check your heart and blood pressure.

Disability. check for signs of brain damage. This includes checking to see how you respond to different verbal and physical stimulation.

Exposure. To remove any chemicals or burn-causing substances from the skin by flushing the injured area with water.

Scenario conclusion : Early delivery of a viable pregnancy (>32 weeks) is attempted after resuscitation as the TBSA(total burnt surface area) is 30-50%.