Medical Surgical Nursing

(Tina Sui) #1

  • Labored breathing or tachypnea (rapid breathing) and other signs of reduced oxygen


levels



  • Erythema and blistering of the oral or pharyngeal mucosa

  • The immediate intervention is intubation and mechanical ventilation

  • If ventilation is impaired by restricted chest excursion, immediate chest escharotomy


is needed



  • ARDS may develop in the first few days after the burn injury secondary to systemic


and pulmonary responses to the burn and inhalation injury


Renal alteration



  • Renal function may be altered as a result of decreased blood volume

  • Destruction of red blood cells at the injury site frees hemoglobin in the urine

  • If muscle damage occurs (from electric burns e..) myoglobin is released from the


muscle cells and excreted by the kidney



  • Adequate fluid volume replacement restores renal blood flow, increasing the


glomerular filtration rate and urine volume



  • If there is inadequate blood flow through the kidneys, the hemoglobin and myoglobin


occlude the renal tubules, resultinh in acute tubular necrosis and renal failure


Immunologic Alterations



  • The immunologic defences of the body are greatly altered by burn injury

  • Serious burn injury diminishes resistance to the infection

  • As a result, sepsis remains the leading cause of death in thermally injured patients

  • The loss of skin integrity is compounded by the release of abnormal inflammatory


factors, altered levels of immunglobulins, impared neutrophil function and a reduction


in lymphocytes (lymphocytopeni)



  • Research suggests that burn injury results in loss of T -helper.cell lymphocytes


Thermoregulatory Alterations



  • Loss of skin results in an inability to regulate body temperature

  • Burn patients may therefore exhibit low body temperature in the early hours after


injury



  • As of hypermetabolism, core temperature increase.

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