A Burn Injury Can Severely Affect A Patient's Physical And E

A Burn Injury Can Severely Affect A Patients Physical And Emotional W

A burn injury can severely affect a patient's physical and emotional well-being. As a nurse, you may be responsible for caring for a patient during any of the three phases of burn injury: emergent, acute, and rehabilitative. It is essential to understand the needs of a burn patient at each stage and appropriate nursing interventions to meet those needs. This understanding will help ensure comprehensive care and promote optimal recovery outcomes.

Paper For Above instruction

Introduction

Burn injuries pose significant challenges to patients because they impact both physical and emotional health. They require carefully staged interventions to address immediate life-threatening issues, ongoing wound management, and long-term rehabilitation. For nurses, understanding the specific goals, assessments, diagnoses, and interventions for each phase is critical for delivering high-quality care that promotes healing and psychological well-being.

Phases of Burn Injury and Corresponding Care Strategies

The progression of burn injury care can be categorized into three phases: emergent, acute, and rehabilitative. Each phase has distinct goals, assessment priorities, nursing diagnoses, and interventions tailored to the patient's evolving needs.

Emergent Phase

The emergent phase occurs immediately following the injury, focusing on airway management, stabilization, and prevention of shock. The primary goal is to ensure the patient’s vital functions are stabilized.

• Goals:
  • Maintain airway patency and adequate respiration.
  • Prevent hypovolemic shock through fluid resuscitation.
  • Minimize further tissue damage.
• Nursing Diagnoses:
  1. Impaired airway clearance related to airway edema as evidenced by stridor and wheezing.
  2. Imbalanced fluid volume: deficit related to increased vascular permeability as evidenced by hypotension and tachycardia.
  3. Anxiety related to trauma and uncertainty about injury severity as evidenced by verbal expressions of fear.
• Objective Assessments:
  • Airway patency and breath sounds examination.
  • Vital signs monitoring including blood pressure, heart rate, and oxygen saturation.
  • Assessment of burn extent and depth using the Rule of Nines or Lund-Browder chart.
• Nursing Interventions (Non-Medication):
  • Establish and maintain patent airway, including suctioning if necessary.
  • Administer oxygen therapy to ensure adequate oxygenation.
  • Begin fluid resuscitation with isotonic IV fluids based on the Parkland formula.
• Acute Phase
• The acute phase spans from the end of initial stabilization through wound closure. Focus shifts to wound care, infection prevention, and pain control.
• Goals:
  • Prevent infection and promote wound healing.
  • Manage pain and support nutritional needs.
  • Prevent complications such as sepsis or contractures.
• Nursing Diagnoses:
  1. Risk for infection related to open burn wound as evidenced by wound appearance and laboratory findings.
  2. Impaired physical mobility related to pain and tissue damage as evidenced by limited range of motion.
• Objective Assessments:
  • Regular wound assessment including size, color, and exudate.
  • Monitoring for signs of infection such as increased redness, swelling, or purulent discharge.
  • Assessment of nutritional status through weight, serum albumin, and nutritional intake.
• Nursing Interventions (Non-Medication):
  • Perform sterile wound care and dressing changes as prescribed.
  • Implement strict infection control measures, including hand hygiene and barrier precautions.
  • Coordinate nutritional support, including caloric and protein intake to promote healing.

Rehabilitative Phase

During rehabilitation, the focus is on restoring function, reducing scarring, and supporting psychological health.

• Goals:
  • Promote functional recovery and prevent contractures.
  • Support emotional and psychological adjustment to physical changes.
  • Achieve the best possible cosmetic outcome.
• Nursing Diagnoses:
  1. Impaired physical mobility related to scar tissue and contractures as evidenced by limited range of motion.
  2. Disturbed sensory perception related to nerve injury as evidenced by paresthesia.
  3. Compromised family coping related to patient’s physical changes and emotional stress.
• Objective Assessments:
  • Assessment of joint mobility and the presence of contractures.
  • Evaluation of scar tissue development and associated pain or discomfort.
  • Assessment of psychological well-being through patient conversations and standardized tools.
• Nursing Interventions (Non-Medication):
  • Implement range-of-motion exercises to prevent contractures.
  • Provide psychological support and counseling referrals as needed.
  • Educate patient and family on scar management and skin care routines.
• Conclusion
• Caring for burn patients requires an understanding of the unique needs at each phase of injury. Nursing care aims to stabilize the patient, prevent complications, promote healing, and support psychological recovery. Detailed assessments, specific diagnoses, and targeted interventions are essential for optimal outcomes. As nurses, providing comprehensive, phase-specific care directly impacts the patient's recovery trajectory and quality of life.
• References
• Heimbach, D. M., Klein, M. B., Pruitt, B. A., & Neidig, J. (2014). Burn Care and Treatment. In Sabiston Textbook of Surgery (20th ed., pp. 985-1020). Elsevier.
• Greenhalgh, D. G. (2016). Burn wound healing. Journal of Burn Care & Research, 37(4), e371-e381.
• Sheridan, R. L., & Kahn, S. A. (2014). Pediatric burns. Critical Care Nursing Clinics of North America, 26(2), 131-142.
• Jayasinghe, K. S., & Grzebieta, R. H. (2015). Epidemiology and prevention of burns in children: an overview. Journal of Injury and Violence Research, 7(2), 87-98.
• Gibran, N. S., et al. (2018). Advances in burn management. The New England Journal of Medicine, 378(13), 1189-1198.
• Harms, B. A., & Loh, S. (2014). Psychological aspects of burn injury recovery. Nursing Clinics of North America, 49(3), 423-432.
• Jeschke, M. G., et al. (2017). Pathophysiological response to severe burns. World Journal of Surgery, 41(1), 11-20.
• Phang, M., & Lee, J. J. (2019). Nursing care of burn patients. Journal of Clinical Nursing, 28(1-2), 124-135.
• Bouwmeester, W., & Di Somma, P. (2021). Burn injury management: recent advances and ongoing challenges. Burns & Trauma, 9, tkab017.
• Herndon, D. N., et al. (2018). Pediatric burn management and rehabilitation. Clinics in Plastic Surgery, 45(1), 27-35.