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?
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
• 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.
• 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
• Inspect the wounds for discoloration or haemorrhage, which indicate
• 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
• 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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