NUR 2790 Module 3 Assignment Phases of Burn Injury
NUR 2790 Module 3 Assignment Phases of Burn Injury
NUR 2790 Module 3 Assignment Phases of Burn Injury
A burn injury can severely affect a patient’s physical and emotional well-being. As a nurse you may be in charge of taking care of a patient during any of the three phases of burns. Please complete the Phases of Burn Injury table to better understand the needs of a burn patient and ways to meet those needs.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Phases of Burn Injury: Patient Care
Heat not only damages skin locally but has many generalized effects on the body. These changes are specific to burn injury and are generally not encountered in wounds caused by other injuries.[3]
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There is generalized increase in capillary permeability due to heat effect and damage. This causes plasma to leak out from capillaries to interstitial spaces. Increased capillary permeability and resultant plasma leak persists till 48 hours and is maximum in first 8 hours. By 48 hours either capillary permeability returns back to normal or they are thrombosed and are no more the part of circulation. This plasma loss is the cause of hypovolaemic shock in burns. The amount of fluid loss will depend on extent of burns. Body surface area burns is usually calculated by Wallace’s rule of ‘9’ in adults and Lund and Browder’s chart in adults and children. Any adult burn more than 15% and pediatric burn more than 10% will land up in hypovolaemic shock if not adequately resuscitated. In burns involving 50% of body surface area, there is maximum possible fluid loss and it remains same even if more than 50% of body surface area is burned.
This generalized increase in capillary permeability is not seen in any other wound. There is only local reaction at the wound site due to inflammation leading to persistent progressive vasodilatation and oedema. Hypovolaemic shock in other major traumatic wounds is usually due to blood loss and requires whole blood replacement immediately.Whereas in extensive burns the whole blood replacement is given after 48 hours.
Following are the causes of blood loss in burns
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Red blood cells are lost in thrombosed vessels underlying the burned skin in the acute phase. Therefore, deeper the burn more is the blood loss. The blood is to be transfused after 48 hours unless otherwise indicated as in pre-existing anemia or whole blood loss due to any other cause.
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Life span of circulating red blood cells is reduced due to the direct effect of heat and they are hemolysed early. Extensive burn also causes bone marrow depression leading to anemia.
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In chronic stage of burns, blood loss from granulating wound, and infection are responsible for anemia. (B)Unlike most of the other wounds, burn wounds are usually sterile at the time of injury. Heat being the causative agent, also kills all the micro-organisms on the surface.It is only after the first week of burns that these surface wounds tend to get infected, thus making burn wound sepsis as the leading cause of death in burns. On the other hand, other wounds e.g., bite wounds, puncture wounds, crush injury and abrasions are heavily contaminated at the time of infliction yet they are rarely the cause of systemic sepsis.