Medical-surgical Nursing Demystified

(^402) Medical-Surgical Nursing Demystified

• Charred black or dry white—indicates death of the tissue from the burn (third-
  degree burn)

INTERPRETING TEST RESULTS

• Pulse oximetry—a sensor is placed on the finger, toe, or earlobe to assess the
  amount of oxygen in the blood to ensure adequate oxygenation.


• Pulmonary function tests show how well the lungs are working. The patient
  breathes into a machine, a spirometer, which records changes in the lung size
  with inhalation and exhalation and the time it takes to perform this test.


• Rule of nines—a way of measurement to estimate the total body surface area
  burned: head, 9 percent; anterior torso, 18 percent; posterior torso, 18 per-
  cent; each leg, 18 percent; each arm, 9 percent; perineum, 1 percent.

TREATMENT

The objective of burn treatment is to prevent infection, decrease inflammation and

pain, and promote healing of the areas. Treatment choices depend on the degree of

burn and the amount of body surface area that was burned. Any second-degree burn

greater than 5 to 10 percent of surface area and all third-degree burns belong in a

hospital, preferably within a specialized burn unit. All electrical burns and burns

of the ears, eyes, face, hands, feet, and perineum require hospital care, as do chem-

ical burns and burns in infants or the elderly.

• Check the area for any exposed electrical wires, if you are present on the scene.


• Use cold water to decrease the temperature of the area for a first-degree burn
  or a small second-degree burn and to stop the burning.


• For chemical burns, ensure that all the chemical has been flushed away.


• For electrical burns, look for entrance and exit wounds.


• Cover the area with dry gauze.


• If the skin is broken (second-degree burn), use a topical antibiotic ointment such
  as silvadene to prevent a secondary bacterial infection before applying the gauze.


• Administer pain medications (ibuprofen, acetaminophen) as needed.


• For third-degree burns, the eschar needs to be debrided (cut away) to allow
  new tissue to grow.


• These wounds are often covered in moist sterile saline gauze, as new tissue
  grows best in this environment. When the gauze dries; it adheres to the dead
  tissue. The area is mechanically debrided when the gauze is removed.