Nursing assignment- pls help

  1. hello everyone! can you please help me with this question

    the question is
    what specific medications would be given to a man who has (according to the rule of nines )38% of his body covered in full thickness burns.(group, generic name, route, and usual dosage)

    i have at the moment,

    topical antibiotic - silver sulfadiazine

    and im thinking probably a penicillin based antibiotic but cant think of any for full thickness burns.

    maybe some type of iv as well ?????
    pls help

    rachiee
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  2. 5 Comments

  3. by   Daytonite
    hi, rachiee, and welcome to allnurses!

    here is information that should get you started with this assignment. . .38% full thickness burns covering the body is a pretty serious case and considered a major burn. the patient needs to be immediately assessed for the patency of his airway and his ability to breathe. if there were problems intubation would be done. the first thing you want to do is prevent hypoxia. iv fluids would be started with large-bore catheters since fluid replacement after extensive burns like this are also a priority. you want to maintain a urine output of 30 to 50 ml per hour. an n/g tube and foley catheter would be inserted. the patient would be kept npo. when finally allowed to eat a high protein, high calorie diet would be given along with a lot of oral fluids. if the patient wasn't able to eat because of burns and swelling around the oral area or esophagus, tpn might be instituted.

    as for medications, a tetanus shot would be given. analgesics would be given for pain. antibiotics would be given to prevent infection (remember the skin is a primary body defense against infection and if 38% of it is burned away, the person's defense is severely compromised). antianxiety agents might be given. with all the fluid replacement that is given, if the patient's renal status could be compromised and diuretics may also be needed.

    these patients usually need to undergo surgery to debride dead and necrotic tissue, eschartomies and skin grafting.

    complications of burns are anemia, hypovolemic shock (due to fluid loss as a result of the loss of skin surface), malnutrition, multiple organ dysfunction syndrome, respiratory collapse and sepsis.

    this is an intensive care nursing situation.
    (pages 146-147, nurse's 5-minute clinical consult: diseases from lippincott williams & wilkins)
    Last edit by Daytonite on Oct 12, '07
  4. by   Daytonite
    here is information on the care of a third-degree wound:
  5. by   rachiee
    thank you so much for that :angel2:
    after doing so many of these case studies my brain is fried lol
  6. by   greatshakes
    Terrific post on burns Daytonite. thanks you've helped me too
  7. by   rachiee
    i have one more quick question for whoever can help.
    in relation to this full thickness burns victim ,

    what inteventions would you put in place and why to stop risk for ineffiecient tissue perfusion related to peripheral constriction secondary to circumferential burn wounds of the arm.

    i dont quite understand... ineffiecient blood supply to tissue ?? what could u do as an intervention ?
    Last edit by rachiee on Oct 12, '07

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