Unfolding Case Study: Burn Injury
Trent University
NURS 3020 Clinical Practice Acute Care
, I attended my third unfolding case study that focused on a burn injury. I prepared for this
lab by reading the Nurse Achieve PowerPoint on burns, completing the seven Elsevier modules
listed on blackboard, and I refreshed my mind on the BSA tools including Lund Browder and the
Rule of Nines. Furthermore, I completed the interactive burn simulation on Nurse Achieve to
stimulate my critical thinking. Going into this lab, I felt confident in my ability to identify the
different types of burns, the expected physiological and metabolic changes and their treatment
options.
We first started by breaking off into two groups where one analyzed the blood work while
the other performed vitals and a head to toe assessment. This made us think on our feet a little
more as there were less people to provide their input although, I liked how it challenged us. We
identified that the patient was experiencing uncompensated metabolic acidosis and what
manifestations to look for, as well as signs of shock as they were in a state of hypovolemia. We
then practiced using the Lund Browder chart to calculate the percentage of burns. As a group, we
struggled using the chart as it was the first time that we had to try and accurately assess the body
surface area, but we realise that this is a specialty skill and those who work in burn units are
trained in using this tool. We concluded that the patient had 18% of her body covered in burns
and proceeded to calculate the amount of fluid resuscitation that was required. We reviewed the
orders and practiced inserting an IV, set up the IV pump for infusion, and carefully reviewed the
monograph regarding IV morphine. Next we were given new orders and we discussed as a group
which ones to prioritize and why. We decided that inserting the foley catheter was the number
one priority followed by wound care, and NG tube management. After discussing our rationale
we then practiced each skill with a partner.
Trent University
NURS 3020 Clinical Practice Acute Care
, I attended my third unfolding case study that focused on a burn injury. I prepared for this
lab by reading the Nurse Achieve PowerPoint on burns, completing the seven Elsevier modules
listed on blackboard, and I refreshed my mind on the BSA tools including Lund Browder and the
Rule of Nines. Furthermore, I completed the interactive burn simulation on Nurse Achieve to
stimulate my critical thinking. Going into this lab, I felt confident in my ability to identify the
different types of burns, the expected physiological and metabolic changes and their treatment
options.
We first started by breaking off into two groups where one analyzed the blood work while
the other performed vitals and a head to toe assessment. This made us think on our feet a little
more as there were less people to provide their input although, I liked how it challenged us. We
identified that the patient was experiencing uncompensated metabolic acidosis and what
manifestations to look for, as well as signs of shock as they were in a state of hypovolemia. We
then practiced using the Lund Browder chart to calculate the percentage of burns. As a group, we
struggled using the chart as it was the first time that we had to try and accurately assess the body
surface area, but we realise that this is a specialty skill and those who work in burn units are
trained in using this tool. We concluded that the patient had 18% of her body covered in burns
and proceeded to calculate the amount of fluid resuscitation that was required. We reviewed the
orders and practiced inserting an IV, set up the IV pump for infusion, and carefully reviewed the
monograph regarding IV morphine. Next we were given new orders and we discussed as a group
which ones to prioritize and why. We decided that inserting the foley catheter was the number
one priority followed by wound care, and NG tube management. After discussing our rationale
we then practiced each skill with a partner.
