Pediatric Nursing Demystified

Signs and Symptoms

First-degree burns:

• Pain due to nerve-ending irritation; worse with touch


• Erythema (redness)
  Second-degree burns:


• Pain from damaged epidermis and dermis


• Red clear fluid-filled blisters
  Third-degree burns:


• Color ranges from red to tan, white, charred brown, or black with a
  dry leathery appearance.


• Absence of sensation.


• Incapable of regenerating skin.
  Fourth-degree burns:


• Brown, black charred muscle, fascia, and bone visible.


• Wound is dry, dull, and leathery in appearance.

Nursing alert While the burn injury appears most acute, additional injury, such

as smoke inhalation resulting in airway constriction or wounds resulting in

excessive bleeding, may be life threatening and need immediate attention.

Test Results

Body surface area determination is critical in determining treatment.

A rule of 9’s measure may be used with specific percentages of surface

area designated for body part involved.

Nursing alert Pediatric scales vary based on the age of the infant or child. Con-

sider child size as well. If a 7-year-old is small and the size of a 5-year-old, use

the scale for the smaller child.

Pulse oximetry: Measures oxygen saturation to determine oxygenation

problem due to damage to airways or lungs from smoke or superheated air.

Pulmonary function tests: Determine lung damage that may impair res-

piration.

Treatments

Immediate:

• Stop the burning.
  Remove the source:
  Flame—cover and smother the fire.
  Hot liquid/chemical—apply cool water to dilute.

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CHAPTER 15/ Integumentary Conditions^337