1. Using the Rule of Nines, A.N. sustained burns to 45% of her body when combing A&P sites.
2. Criteria to assess includes burns on the face and neck, singed nasal hair, hoarse, dry cough, bloody/sooty sputum, labored respirations. Additionally, edema, blisters, and ulcerations along the mucosal lining of the oorpharyngeal and laryngeal sites. The edema may continue to increase for 24-48 hours post injury, so close pulmonary assessment is pertinent. Asses initially for need of intubation with mechanical ventilation, continuous O2 saturation monitoring, pulmonary toilet, and CXR. Careful assessment in the order of respiratory distress and airway obstruction is essential. Assess for deep facial and neck burns, stridor, accessory muscle use, hypoxia, blistering/edema to the oropharyngeal airway, continuous ABG assessment in the order of intubation and mechanical ventilation need.
3. H&G 20 and 51 increase during the first 24-48 hours post inhalation injury secondary to hemoconcentration related to intravascular fluid volume loss. This is proportional to the level of fluid volume. As fluid returns to the intravascular space, H&H levels return to normal. H&H should decrease with adequate hydration. Serum potassium of 4.9 initially is expected to increase secondary to cellular lysis and fluid shifts to extracellular …show more content…
Once fluid resuscitation has begun, narcotic analgesics are administered IV to control pain, which should be evaluated and adjusted continuously per patient status. Analgesics are most effective if given on a scheduled basis rather than per request, as effective pain management is responsible by the activated sympathetic nervous system, vasoconstriction, which decreases blood flow to the wound, which delays wound healing. Do not use IM injections during the emergency period secondary to poor absorption. The most common, in the early, acute phase of a burn injury, includes opioid agents such as morphine sulfate, fentanyl, and