case study: Burn

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please help me identify nursing assessment, problems identified, and interventions appropriate, the immediate priority (priorities) and the long term priorities for this patient? Include how i would evaluate my nursing care in this case study. a 25-year-old male fell out of a tree and struck a hot charcoal grill, lacerated his left leg, and his clothes caught fire Once brought to ED, his burns were estimated to be partial and full thickness over his face, neck, trunk, right upper arm, and left leg. He is alert, and his voice is slightly hoorifice His left leg is splinted, and the lacerated wound is cleaned and debrided . IV is started, and indwelling urinary catheter is inserted into bladder. Using the Lund-Browder chart, his total body surface affected is 46%. Assuming he did not receive any fluids prior to arriving at the ED 1 hour after burn, what would you expect for IV fluid infusion over the next twenty four hours?.

please help

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Specializes in Utilization Management.

In the time it took you to post this case study multiple times, you could've gotten out your books and finished the assignment. Just my :twocents:

What have you come up with so far??

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Wild guess....LR

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Oh and Boog's girl, this person was probably asking the question because they didn't know, not because they were being lazy and didn't look in their book. I don't get why people post responses like yours. Just saying

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Specializes in Utilization Management.
Oh and Boog's girl, this person was probably asking the question because they didn't know, not because they were being lazy and didn't look in their book. I don't get why people post responses like yours. Just saying

LOL riiiiiiight...

People post responses like mine (and you can read what I'm about to write anywhere on the site) b/c students are constantly posting verbatim homework questions without so much as an attempt to show that they've put forth any kind of effort on their own. I know for a fact that nursing assessments regarding burns are in any Med-Surg or Critical Care textbook, along with interventions. And at the very least...there's Google. :idea:

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Specializes in ED.
LOL riiiiiiight...

People post responses like mine (and you can read what I'm about to write anywhere on the site) b/c students are constantly posting verbatim homework questions without so much as an attempt to show that they've put forth any kind of effort on their own. I know for a fact that nursing assessments regarding burns are in any Med-Surg or Critical Care textbook, along with interventions. And at the very least...there's Google. :idea:

And let's not overlook or forget the fact that the OP has posted this question once already.

Just today I had to do a care plan and nurses' notes for a pt with burns and I had to document what type of IV fluid I would anticipate to be ordered and how much to infuse. I googled and came up with the correct answer looking at the first website that came up.

This stuff isn't hard but I do find that MANY students are being lazy. In the time it takes to post all of the homework question or patient info, she could have easily googled and found ALL the info needed. I'm not going to do anyone's homework for them. I can barely do my own but you can be d@mn sure I'm going to at least attempt to find the answer on my own.

Give a man a fish and he'll eat for the night. Show the same man HOW to fish and he eats for a lifetime.

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sorry guys that you all feel this way, i am not lazy but the problem is that i have started the homework but for reasons, i keep getting stuck. please help me!:heartbeat

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Specializes in Emergency/Cath Lab.

How have you gotten stuck? simply coming and saying do the work for me isnt enough for help. What kind of fluids are you going to be running? at what rate do you do fluid resuscitation for burn victims? look for that kind of stuff and at least put something on the table for work that you have done.

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Help us help you. What direction are you going in? What don't you understand? You need to put some effort into the project, also. Remember, you do need to know how to figure this stuff out on your own. When you take the NCLEX, posting questions on this forum to get the answers to questions you are stuck on, isn't allowed.

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i am very sorry guys, so here is what i came up with but i still need your help.

This is a case of a 25-year-old male patient who fell out of a tree and struck a hot charcoal grill. He tears his left leg, and his clothes caught fire. On his admission to the ED, the 25 years old is diagnoses with a partial and full-thickness burn over his face, neck, trunk, right upper arm, and left leg. Using the Lund-Browder chart, a quick assessment based on the rule of nine estimate the extend of his burn injury at 46% of his TBSA (Total Body Surface Area). IV is started, and indwelling urinary catheter is inserted into bladder. His left leg is splinted, and the lacerated wound is cleaned and debrided. He is alert, and his voice is slightly hoorifice. I know that in the first 48 hours of burn, patients will lose fluids from the vessels, sodium chloride and protein which flow into the injured area causing blisters, swelling, low urine output and low blood pressure. So the important factors here to consider will be to provide this patient with fluids and electrolytes which have already been done. He will be getting an IV Lactated Ringers of 750ml per hour since his burns were 46%; antibiotics, which are usually topical should be prescribed to prevent infections and bacteria growth. For this patient, Silvadene will ideal prescription which is used for more severe burns. Silvadene is a sulfa medicine used to prevent and treat bacterial or fungus infections. This medication should be applied using a sterile technique to affected areas and the areas should be washed before applying. Urine output will be monitor for volume and signs of blood. Tetorifice toxoid should be administered for immunization. For this patient, I am going to assess and manage level of pain and anxiety. In his case, pain medication will be administered to ensure that this patient is as comfortable as possible. Such medication that can be administer to the patient can be Morphine Sulfate, Demerole and/ or vicodin which are prescribed for severe pain which I believe is the state in which this 25 years old is in . I am going to provide support to patient and family during initial crisis phase to ensure the teaching, understanding and the involvement of everybody. After this, I will place the patient in position that prevents contracture formation. I will assess nutritional needs and begin feeding patient by most appropriate route as soon as possible because feeding the patient by most appropriate route will increase intestinal blood flow, and promotes optimal conditions for wound healing. Adequate calories, supplemental vitamins and proteins should be provided because failure to do so may leads to malnutrition and delayed healing. Proteins powder can also be added to food and liquids. After the patient wound have healed and the patient is able to resume a level of self-care activity, rehabilitation phase begins approximately as early as 2 weeks or as long as 7 to 8 months after the burn injury. At this phase, my goal will be to assist the patient in resuming a functional role in society and to accomplish functional and cosmetic reconstructive surgery. After this, I will prepare for discharge home or transfer to rehabilitation hospital.

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Looks good to me so far. How about any lab values that might be associated with the drugs he is taking? Maybe add what he rated his pain at before and after meds? Maybe add a wound assesment, what did it look like? Maybe add his I/O? I would go into more detail involving what type of teaching you would provide to pt/family, maybe give some specific details about interventions. You are on the right track, keep up the good work!

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Specializes in Emergency/Cath Lab.

WEre you guys taught that you only run at 750ml per hour based on % burned? we learned a completely different way to calculate total volume to be infused the first 8 then the next 16 hours

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