Beruflich Dokumente
Kultur Dokumente
NUR 217
Functions of the Skin
Protection Function
Sensory Function
Water/ Electrolyte Balance
Temperature Regulation
Excretory Organ
Produces & Absorbs Vitamin D.
Body Image
Burns
Prognosis depends on
Depth of the burn.
Extent of the burn.
Condition of the patient.
Age of the patient.
Pulmonary
Patho-physiology
Zone of Stasis
Zone of Hyperemia
Estimated Percentage of BSA
Rule of Nines:
Adult
Child adapted rule of nines
Lund and Browder method
See figures
Palm method
Patients palm is approximately 1%
Characteristics of Burns
No edema
Homografts
Allografts
Cadaver skin
Xenografts
Heterografts
Pig skin
Autografts
Own skin
Exposure Method
No dressing
Advantages
No painful dressing changes.
Less equipment.
Infection can be detected early.
Large number of patients can be treated.
Disadvantages
Not suitable for burns of the hands & feet.
Unsuitable in patient transport.
Less effective when other injuries exists.
Additional metabolic stress: hypothermia issues.
Open Method
+ Topical Agent
Disadvantages
Delay in eschar separation.
Increase risk of sepsis.
Increase in patient discomfort.
Criteria for Topical Agents
Effective against Gm Neg organisms.
Clinically effective.
Penetrates eschar>>>> but not
systemically toxic.
Does not lose its effectiveness.
Cost effective, available & acceptable to
patient.
Inexpensive & easy to apply.
Topical Chemotherapy
Silver Sulfadiazine (Silvadene)
Duration-
from major wound closure to return to
individuals optimal level of physical &
psychosocial adjustment.
Priorities-
Prevention of scars & contractures.
Physical, occupational & vocational
rehabilitation.
Functional & cosmetic reconstruction.
Psychosocial counseling.
Phase 3
Nursing Diagnoses
Activity intolerance
Knowledge deficit
Ineffective individual coping
Body image disturbance
Total Parenteral Nutrition
TPN solutions contain
Water
Amino acids
Glucose
Vitamins
Electrolytes
Concentrations provide enough calories to
meet the pts daily nutritional needs
TPN Indicated:
10% deficit in body wt.
Inability to take oral food or fluids within 7
post- op days.
High metabolic or Hyper-catabolic
situations
Major infection with fever.
Major burns.
TPN Nursing Diagnoses
Acute