an "alteration in health" would be anything that is abnormal. shock would be a medical diagnosis that would be made based upon evidence presented. i didn't see any evidence (symptoms) of shock listed in the scenario. neither were scars discussed and they are a long term complication. stay focused. the issue at hand is the immediate treatment of an acute burn patient.
kevin lewis, 22 year old weighing 72 kgs, was involved in an industrial fire at 1130 hours. kevin was welding a steel structure when a spark from his torch ignited a barrel of flammable material that was inadvertently placed in his work area. kevin sustained full thickness burns over the upper half of his chest and circumferential burns to both arms. he also sustained superficial partial thickness burns to his face, neck and both hands. his entire abdomen, upper half of his back and front of his upper legs sustained deep partial thickness burns. the hospital just bought a new pressure garment for treating burns. in the past, burns were treated with a variety of different interventions. some staff are still unsure of what is best. clue: there is uncertainty among staff about best practice in treatment of a particular alteration in health. what is that alteration in health? focus your question on possible management alternatives for this alteration in health, being sure to include at least the one alternative discussed in the scenario?
re-read the scenario carefully. it tells you what burn injuries the patient has. it also tells you that the hospital has acquired a new piece of equipment for treating burns. the nursing staff, it says, is not sure about what burn treatment is best. nothing was even ordered for this patient. . .the staff is just opinionated, as staff tends to be, about whether some treatments work better than others. it seems to me that this scenario is saying,
"there are a number of treatment choices available for the treatment of acute burns. pick one and discuss how it would be applied to treat the patient described above."
does that make things clearer? the scenario is asking you to be the doctor
and call the shots for the burn care of the fella insofar as the doctor's role in this would be concerned. you get to choose the treatment method you feel is the best. it doesn't even say that you have to defend your choice.
to do this you will have to read up on the medical
treatment of acute burns. you will need to pick one and know what the doctor would order. it seems the scenario might be trying to goad you into finding out information on this new pressure garment which, by the way, would require a physician's order to use. if information on burn care isn't in your textbooks, search the internet.
what is the alteration in health? that would be determined by doing an assessment of the patient based on the information you have been given and determining the nursing problems and, thus, the nursing diagnoses. so, you need to know the signs and symptoms a person with first, second and third degree burns will experience and what the nursing considerations for care will be. in addition, based on the medical treatment you have chosen, you will also include the nursing responsibilities in carrying that out as well. without giving you the specific nursing diagnoses, the categories of nursing problems here would be
- gas exchange/tissue perfusion
- airway management
- food, fluids and electrolytes
- control of body temperature
- safety needs
- emotional support
- self-esteem needs