Burns Actvity

ACTIVITY: BURNS
Name: TERCEÑO, Joshua Jose G. Grade: _________________
Section: 3AN
Direction:
Read the situation carefully and answer the questions provided.
Situation:
Rodel is a 32-year-old male. He was cooking in his kitchen when the gas range caught on fire at 2300. The entire house was
engulfed in flames when the fire department arrived on scene. The neighbor called 911 when he smelt smoke. Brad was found
unconscious by the firefighters and was pulled out. He was stabilized on scene and was rushed to Ospital ng Makati via ambulance.
While enroute, the paramedics started an 18-gauge IV in the right C and had Rodel on 100% O2 non-rebreather. Paramedics
alerted Emergency Department of an estimated ETA of 5 minutes. Upon arrival at the ED, Brad was found to have stage 3 burn
wounds on his anterior and posterior torso and entire left arm with stage 2 burns on his anterior neck. Rodel was at risk for smoke
inhalation and a compromised airway, so RT intubated him and fluid resuscitation was initiated. Upon arrival to Emergency
Department the nurse assesses Rodel and vital signs were as follows: blood pressure of 92/58, heart rate of 112, oxygen saturation
of 91% respiratory rate of 22, and a temperature of 97.4°F. During transportation an 18-gauge IV was started in right AC and 1 liter
of Lactated Ringers (LR) was administered. A non-rebrether O2 applied on 100% and 15 L to achieve a saturation of 93%. HIs
reported weight in the ED was 75 kg, and a body surface area of 2.0 m2.
Rodel was transferred to the Burn Intensive Care Unit (BICU) at 0030, where fluid resuscitation was continued. At this time Rodel
had already received 2 bags of LR. 1,500 mL/m2) + [(25 + %
TBSA burned) x (m2 x 24)] = total maintenance fluid (mL) to be given over 24 hours. (1,500 mL/ 2.0) + [(25 + 27% TBSA) x (2.0 x
24) = (750) + [52 x 48] +750 + 2,496 = 3,246 mL to be given over 24 hours for fluid resuscitation at a rate of 270.5 mL/hr.
Rodel was admitted to the burn unit at 0700 post surgery, and remained a patient on the burn unit for 4 weeks. Goals of his stay
included monitoring vital signs, preventing infection, pain management, wound care, adequate nutrition, physical therapy, and
psychosocial support.
Questions:
1.During the initial fluid resuscitation for Rodel’s burn, lactated ringers were the fluid of choice to be infused. Why would the nurse
choose lactated ringers the preferred fluid of administration?
Lactated Ringer’s Solution is the most common fluid choice for burn resuscitation because it is slightly hypotonic,
treating both intravascular volume losses and extracellular sodium losses.
2. A nurse is assessing a burn patient that came to the burn ICU. What total body surface area needs to be burnt in order to
administer fluid resuscitation?
20% of the total body surface
3. Determine the total body surface area using the following:

a. Palmer method
b. Wallace Rule of Nines
Nine rules: Anterior Torso 18% +
Posterior Torso 18% +
Lest arm 9% +
Neck 1% =
46% TBSA
c. Parkland formula
4ml x 46%TBSA x 75kg = 13,800 = 6,900 for the first 8 hours.
& 6,900 for the next 16 hours
4. Rodel experienced a variety of complex complications after his burn injury. He suffered physiological issues with the burns and
psychological referrals Rodel would need?
Psychosocial, occupational therapy, physical therapy, housing assistance, drug rehabilitation.
5. What is your plan of care for Rodel? Pls provide an NCP for Rodel.
NCP: Risk for prone behavior related to lack of knowledge about the disease.
Assessme Nursing Inference Planning Interventions Rationale Evaluation

nt
Diagnosis
Subjective: Risk for High blood After 8hrs of ● Define and ● Provides basis for After 8hrs of
prone pressure nursing state the limits understanding nursing
“Can you
behavior (HBO) or interventions the of desired BP, elevations of BP, interventions
see?! I’m
related to hypertension patient will Explain and clarifies the patient
burned
lack of in the verbalize hypertension misconceptions had
and no one
knowledg arteries. understanding and its effect ang also verbalized
will like me
e about Arteries are of the disease on the heart, understanding understandin
anymore!”
the vessels that process and blood vessels, that high BP can g of the
as
disease carry blood treatment kidney and exist without disease
verbalized
from the brain. symptoms or process and
by the
pumping ● Assist the even when treatment.
patient
heart to all patient in feeling well
the tissues identifying ● These risk factors
Objective: and organs of modifiable risk have been shown
the body. factors like diet to contribute to
T: 37.2C High blood high sodium hypertension
PR: 85 pressure saturated fats ● Lack of
does not and cholesterol cooperation is
RR: 18 mean ● Reinforce the common reason
BP: 120/80 excessive importance of for failure of
emotional adhering to the antihypertensive
tension, treatment therapy.
although regimen and ● Decreases
emotion keeping follow peripheral venous
tension and up pooling that may
stress can appointments. be potentiated by
temporarily ● Suggest vasodilators.
increase frequent
blood position
pressure changes, leg
exercise when
lying down.

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ACTIVITY: BURNS

Name: TERCEÑO, Joshua Jose G. Grade: _________________

20% of the total body surface

3. Determine the total body surface area using the following:

Nine rules: Anterior Torso 18% +

Posterior Torso 18% +

4ml x 46%TBSA x 75kg = 13,800 = 6,900 for the first 8 hours.

& 6,900 for the next 16 hours

Psychosocial, occupational therapy, physical therapy, housing assistance, drug rehabilitation.

Assessme Nursing Inference Planning Interventions Rationale Evaluation

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