Discussion NUR117: Body Burns Care

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Discussion NUR117: Body Burns Care

Discussion NUR117: Body Burns Care

7. A nurse is caring for a child who has partial-thickness burns on more than 40% of his body. Which of the following fluids prescribed by the provider should the nurse administer to the child in the 24 hr?

Body Burns Care

Body Burns Care

Serious burn requiring hospitalization – Greater than 15% burns in an adult
– Greater than 10% burns in a child
– Any burn in the very young, the elderly or the infirm
– Any full thickness burn
– Burns of special regions: face, hands, feet, perineum
– Circumferential burns
– Inhalation injury
– Associated trauma or significant pre-burn illness: e.g. diabetes

First aid
• If the patient arrives at the health facility without first aid having been given,
drench the burn thoroughly with cool water to prevent further damage and
remove all burned clothing.
• If the burn area is limited, immerse the site in cold water for 30 minutes to
reduce pain and oedema and to minimize tissue damage.

• In all cases, administer tetanus prophylaxis.
• Except in very small burns, debride all bullae. Excise adherent necrotic (dead)
tissue initially and debride all necrotic tissue over the first several days.
• After debridement, gently cleanse the burn with 0.25% (2.5 g/litre)
chlorhexidine solution, 0.1% (1 g/litre) cetrimide solution, or another mild waterbased antiseptic.
• Do not use alcohol-based solutions.

Daily treatment
• Change the dressing daily (twice daily if possible) or as often as necessary to
prevent seepage through the dressing. On each dressing change, remove any
loose tissue.
• Inspect the wounds for discoloration or haemorrhage, which indicate
developing infection.
• Fever is not a useful sign as it may persist until the burn wound is closed.
• Cellulitis in the surrounding tissue is a better indicator of infection.
• Give systemic antibiotics in cases of haemolytic streptococcal wound infection
or septicaemia.

Healing phase
• The depth of the burn and the surface involved influence the duration of the
healing phase. Without infection, superficial burns heal rapidly.
• Apply split thickness skin grafts to full-thickness burns after wound excision or
the appearance of healthy granulation tissue.
• Plan to provide long term care to the patient.

 

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