HESI Case Studies--Pediatrics-Burns

HESI Case Studies--Pediatrics-Burns - What is the first step in assessing a patient with a major burn injury? ️️ Perform a primary survey focusing on airway, breathing, and circulation (ABC). - Why are inhalation burns particularly dangerous? ️️ They can cause airway swelling, carbon monoxide poisoning, and impaired gas exchange. - How do thermal burns affect capillary integrity? ️️ They increase capillary permeability, causing fluid leakage into the interstitial space. - Why should burn wounds not be cooled with ice? ️️ Ice can cause further tissue damage and exacerbate hypothermia. - What is the key clinical sign of carbon monoxide poisoning in burn patients? ️️ Cherry-red skin color and altered mental status. - Why are prophylactic antacids or proton pump inhibitors given to burn patients? ️️ To prevent stress ulcers (Curling's ulcers) from developing in the gastrointestinal tract. - How does a burn injury compromise the immune system? ️️ It decreases white blood cell function and disrupts the skin barrier, making infection more likely. - Why is early surgical debridement important in full-thickness burns? ️️ To remove necrotic tissue and reduce bacterial colonization. - What should be assessed when circumferential burns are present? ️️ Distal pulses, capillary refill, sensation, and movement to identify vascular compromise. - How is hyperkalemia managed in burn patients during the acute phase? ️️ Through measures like calcium gluconate, insulin with glucose, or dialysis if severe. - Why is nasal flaring or intercostal retractions concerning in a burn patient? ️️ They may indicate respiratory distress or impending airway obstruction. - What does persistent tachycardia in a burn patient suggest? ️️ Possible inadequate fluid resuscitation, pain, or early sepsis. - Why is wound care with antimicrobial agents critical in burn management? ️️ To prevent infection and promote a moist environment for wound healing. - What is the significance of a pale or dusky appearance of tissue under a burn wound? ️️ It may indicate poor perfusion or tissue necrosis. - Why are frequent neurological checks necessary for patients with facial or neck burns? ️️ To monitor for cerebral hypoxia or carbon monoxide effects. - How does electrical burn injury affect muscle tissue? ️️ It can cause rhabdomyolysis, leading to muscle breakdown and myoglobin release. - Why is maintaining normothermia a priority in burn patients? ️️ Hypothermia can slow healing, worsen shock, and increase mortality risk. - What does a sudden decrease in urine output indicate in a burn patient receiving fluid resuscitation? ️️ Possible acute kidney injury or inadequate fluid resuscitation. - Why are high-protein diets essential for burn patients? ️️ To support tissue repair and counteract muscle catabolism. - How does deep partial-thickness burn healing differ from superficial burns? ️️ Deep partial-thickness burns may require more time to heal and carry a higher risk of scarring. - Why should burn wounds be covered immediately after injury? ️️ To reduce fluid loss, minimize infection risk, and maintain warmth. - How is a circumferential burn causing vascular compromise treated? ️️ By performing an escharotomy to relieve pressure. - What is the rationale for frequent glucose monitoring in burn patients? ️️ Hyperglycemia from the stress response can impair healing and increase infection risks. - Why are fluid and electrolyte shifts so critical during the first 48 hours after a burn? ️️ Fluid loss and cellular damage alter sodium, potassium, and protein levels, leading to potential imbalances. - What early signs suggest wound infection in a burn patient? ️️ Increased redness, warmth, swelling, or purulent drainage from the wound. - Why are respiratory complications common in patients with large burns? ️️ Smoke inhalation, fluid shifts, and systemic inflammation can impair lung function. - How does smoke inhalation affect carbon dioxide levels in the blood? ️️ It can lead to hypercapnia due to impaired gas exchange.