Medical Surgical Nursing

(Tina Sui) #1

  • Sympathetic stimulation during the emergent phase causes reduced GI motility and


paralytic ileus



  • Auscultate the abdomen to assess bowel sounds which may be reduced

  • Monitor for n/v and abdominal distention

  • Clients with burns of 25% TBSA or who are intubated generally require a NG tube


inserted to prevent aspiration and removal of gastric secretions


Skin Assessment



  • Assess the skin to determine the size and depth of burn injury

  • The size of the injury is first estimated in comparison to the total body surface area


(TBSA). For example, a burn that involves 40% of the TBSA is a 40% burn



  • Use the rule of nines for clients whose weights are in normal proportion to their


heights


Classification of Extent of Burn Injury



  1. Minor Burn Injury



  • Second-degree burn of <15% total body surface area (TBSA) in adults or <10%


TBSA in children



  • Third-degree burn of <2% TBSA not involving special care areas (eyes, ears, face,


hands, feet, perineum, joints)



  • Excludes all patients with electrical injury, inhalation injury, or concurrent trauma and


all poor-risk patients (eg, extremes of age, intercurrent disease)



  1. Moderate, Uncomplicated Burn Injury



  • Second-degree burns of 15–25% TBSA in adults or 10–20% in children

  • Third-degree burns of <10% TBSA not involving special care areas

  • Excludes electrical injury, inhalation injury, or concurrent trauma and all poor-risk


patients (eg, extremes of age, intercurrent disease)



  1. Major Burn Injury



  • Second-degree burns >25% TBSA in adults or >20% in children

  • All third-degree burns >10% TBSA

  • All burns involving eyes, ears, face, hands, feet, perineum, joints

  • All inhalation injury, electrical injury, or concurrent trauma, and all poor-risk patients

Free download pdf