Burn Victim Assessment

Calculate her fluid requirement using the Parkland formula. Explain the time intervals and amounts for each.

The patient’s weight is 110 pounds. This weight is first converted to kg, which is 50kg. The patient weight, which is 50kg, is multiplied by the amount of fluid, which is 4ml, and the total burned surface area, which is 30%.  The result of this is 6000 (Ete et al., 2019). This result is divided into two, and the first 3000ml is given in the first six hours. The remaining 3000 ml is divided into 16 hours, which is given at the rate of 187.5 ml per hour, and the remaining 1500 ml is given for the next eight hours.

1 pound = 0.454 kg

110= 50kg

Fluid requirement = 50x 30 x 4ml

= 6000ml

What assessment findings would corroborate this concern?

There are a couple of assessment findings that can reveal possible smoke inhalation. One of the ways of examining smoke inhalation is to examine the lung sounds and the respiratory airways.  The patient can present with hoarseness, stridor, wheezing, or rhonchi due to chemical damage to the trachea and bronchi (Gupta et al., 2018). Victims of smoke inhalation should be checked for any thermal burns to the airways, chemical damage, and systemic poisoning. Examination of the airway should reveal soot, while blisters in the mouth reveal thermal burn (Gupta et al., 2018). The systemic endpoint of smoke inhalation injury is hypoxia. Hypoxia will cause poor ventilation, reduced oxygen capacity, and reduced oxygen use due to hydrogen cyanide. The patient will present with anxiety, stupor, and agitation (Gupta et al., 2018).

What is the drug of choice for pain relief, and how should it be given?

For hospitalized burn victims, opioids are the mainstay treatment in managing burn pains. This class of medications is preferred since they are readily available and cheap (Griggs et al., 2017). Opioids are administered through the intravenous route. I will give the patient morphine since it is highly recommended for managing severe pain. This medication works by blocking opioid pain receptors (Griggs et al., 2017). Morphine will be given by being injected into the veins. The drug dosage will be determined by the severity of the pain, the patient’s weight, and pain tolerance.

What nutritional requirements are necessary for the client’s burns to heal?

It is essential to implement several nutritional strategies to promote wound healing of the patient’s burns. The patient should have a daily intake of 25kcal/kg (Clark et al., 2017). The patient should consume meals rich in carbohydrates and proteins. They will provide energy and help in the building of muscles. This food should be taken within 36 hours of the burn injury. Food rich in proteins and carbohydrates will reduce proteolysis (Clark et al., 2017). They should also take food rich in vitamins. Vegetables and fruits are rich in vitamins, and they help in skin repair (Clark et al., 2017). This patient must take the recommended daily caloric intake to minimize hyperglycemia resulting from the burns. They will also help to prevent nutrient deficiency and promote wound healing and rapid healing. Effective nutrition helps prevent metabolic inconsistencies during the treatment process and reduce complications such as skin infections (Clark et al., 2017).

What measures are taken with the client to prevent infection?

There are many ways of preventing infections in burn patients. The nurse must carefully handle the affected area. Dressing changes should be done more often to ensure there is no bacterial overgrowth (Palmieri, 2019). There should be a constant inspection of the wound for any sign of infection. Furthermore, antiseptics should be used.  An example of an antiseptic that can be used is silver sulfadiazine. It is applied to the affected area to prevent infection (Palmieri, 2019).

References

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

Ete, G., Chaturvedi, G., Barreto, E., & Paul M, K. (2019). Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns. Chinese Journal of Traumatology, 22(2), 113-116. https://doi.org/10.1016/j.cjtee.2019.01.006

Griggs, C., Goverman, J., Bittner, E. A., & Levi, B. (2017). Sedation and pain management in burn patients. Clinics in Plastic Surgery, 44(3), 535-540. https://doi.org/10.1016/j.cps.2017.02.026

Gupta, K., Mehrotra, M., Kumar, P., Gogia, A. R., Prasad, A., & Fisher, J. A. (2018). Smoke inhalation injury: Etiopathogenesis, diagnosis, and management. Indian Journal of Critical Care Medicine, 22(3), 180-188. https://doi.org/10.4103/ijccm.ijccm_460_17

Palmieri, T. L. (2019). Infection prevention: Unique aspects of burn units. Surgical Infections, 20(2), 111-114. https://doi.org/10.1089/sur.2018.301

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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.

Burn Victim Assessment

Instructions
In a two-page APA formatted paper, discuss the following:
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.
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 findings would corroborate this concern?
The client is in severe pain. What is the drug of choice for pain relief, and how should it be given?
What nutritional requirements are necessary for the client’s burns to heal?
What measures are taken with the client to prevent infection?

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