Burn Victim Assessment

Burn Victim Assessment

Fluid Replacement Using Parkland’s Formula

Fluid replacement is crucial for the recovery of burn victims. For the calculation of the fluid required to be administered to the patient, the Parkland formula is used. This formula states that the patient should receive 4ml of fluids per kilogram per body surface area. In this case, provided, the weight of the client is 110 pounds, which is equivalent to 49.8 kilograms, and the total burnt surface area is 30%. Therefore, the total amount of fluid required is 4ml*49.8 kg*30 % = 5976 ml. In the fluid administration, half of the fluid should be administered within the first 8 hours from when the burn occurred. The other half should be given in the next 16 hours. For this case, 2988 mL should be administered in the first eight hours, and then the rest should be administered over the next 16 hours. The client was admitted at 0400, having been burnt at 0200. Therefore, the client is supposed to receive 2988 mL over the remaining 6 hours of the first eight hours. Consequently, the fluid should be administered at 498mls/hour. From 1000 to 0400 of the next day, the 16 hours, the fluid should be administered at 186.75 ml/hour.

Assessment of Smoke Inhalation

From the history of the incident presented in the case scenario, the client was exposed to smoke inhalation injury ,which could be diagnosed following a thorough assessment to look for signs of inhalation of smoke. These signs include soot around the nostrils, singed hairs around the nose, hoarseness of voice or difficulties in speaking, abnormal breath sounds such as stridor and wheezing, coughing accompanied by black sputum, shortness of breath/respiratory distress, signs of hypoxemia like cyanosis, and altered mental status secondary to hypoxia. Any of these symptoms would suggest internal injury associated with the inhalation of hot air in the smoke that may have caused an internal injury in the upper respiratory system and be responsible for the signs stated above.

Pain Management

            Burn victims experience different degrees of pain and discomfort. For instance, 1st-degree burns are limited to the epidermis and are less painful, only presenting with mild discomfort. The 2nd-degree burns, partial-thickness, involve the epidermis and the superficial portion of the dermis. This injury is very painful. Deep-degree burns involve the epidermis and dermis and may not cause much pain. Full-thickness burns, 3rd degree, involve all the layers of the epidermis and dermis extending to the subcutaneous tissue. Usually sustained the body is subjected to direct heat. Lastly, the 4th-degree burns involve all the tissues and bone and are not painful (Żwierełło et al., 2023). In our scenario, the client has partial-thickness burns and experiences pain. The drug of choice for relief of severe pain should be an opioid analgesic. Morphine sulfate is the drug of choice and should be administered intravenously due to jeopardized circulation that can alter absorption in other administration routes.

Nutritional Requirements

The burn victims should be subjected to a diet that is aimed at facilitating healing and recovery. For instance, there should be increased caloric intake to meet the increased metabolic demands. Secondly, high protein intake for tissue repair and immune functioning, 1.5-2 grams of protein is recommended per kilogram per day. Increased vitamins and mineral intake to foster wound healing. Hydration is vital to maintain the fluid balance even after the initial fluid resuscitation. Lastly, the client should be advised to take small, frequent meals to manage the potential gastrointestinal issues (Clark et al., 2017).

Infection Prevention

            Burns subject the victims to open wounds, which increases the risk of infections secondary to a compromised skin barrier,r which prevents the pathogens from entering the body systems. For this reason, measures should be put in place to prevent the client from contracting an infection. These measures include ensuring aseptic techniques are applied during the care of the patient, like dressing. Secondly, wound care activities such as regular, thorough, and debridement of the dead tissue are done. Thirdly, topical antimicrobial agents should be applied to the wound to prevent bacterial infection. Fourthly, isolation precautions should be taken to limit exposure of the client to infections. The fifth measure is the administration of systemic antibiotics in case of any signs of infection. Lastly, as supported by Coban (2012), close monitoring of the patient is crucial to mitigate the risk of infections through timely diagnosis.

References

Clark, A., Imran, J., Madni, T., & Wolf, S. E. (2017). Nutrition and metabolism in burn patients. Burns & Trauma, 5(1). https://doi.org/10.1186/s41038-017-0076-x

Coban, Y. K. (2012). Infection control in severely burned patients. World Journal of Critical Care Medicine, 1(4), 94. https://doi.org/10.5492/wjccm.v1.i4.94

Żwierełło, W., Piorun, K., Skórka-Majewicz, M., Maruszewska, A., Antoniewski, J., & Gutowska, I. (2023). Burns: classification, pathophysiology, and treatment: a review. International Journal of Molecular Sciences, 24(4), 3749. https://doi.org/10.3390/ijms24043749

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Burn Victim Assessment

Scenario
You are working the night shift on a medical-surgical unit. Your assignment includes a 19-year-old woman admitted early this morning. She has sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back.
Instructions
1. In a two-page APA formatted paper, discuss the following:
2. The staff are following the Parkland Formula for fluid resuscitation. The client arrived at 0200 and was admitted at 0400. She weighs 110 pounds. Calculate her fluid
requirement, using the Parkland formula. Explain the time intervals and amounts for each.
3. The client was sleeping when the fire started and managed to make her way out of the house through thick smoke. You are concerned about possible smoke inhalation. What assessment finding would corroborate this concern?
4. The client is in severe pain. What is the drug of choice for pain relief, and how should it be given?
5. What nutritional requirements are necessary for the client’s burns to heal?
6. What measures are taken with the client to prevent infection?