Question

Hi, please help with answers to questions below in 100-250 words well-developed paragraphs.

Case Scenario: Mr. S is a 38-year old patient who has been admitted to the burn center with full thickness burns over 50% of his body. He was working under a truck when it caught fire, trapping him. He has no prior health issues, except for possibly alcoholism. The specialist gave beginning orders of IV therapy of lactated ringer running wide open, pain medications, constant monitoring of blood pressure, oxygen saturation, and lab work every two hours.

1. Question: Describe the pathophysiology of the extensive burn, detailing what happens in your body. You will need to defend your answer using specific facts, data, and other information drawn from the textbook and at least one other supplemental source.

Case Scenario: Baby S (a 3-month old baby boy) was brought to the clinic by his foster mother. He has been in her care only 24 hours and came with some problems due to lack of care. He has an inflamed bottom near his scrotal and anus. The foster mother states that he has been crying nearly continually since he came to her, and he is very uncomfortable when he urinates. He looks dehydrated as his lips are dry and skin appears dry. She has attempted to put some cream on the bottom, with no effect.

2. Question: Describe the type of infection this may be and why. Include in your answer specific facts, data, examples, and other information drawn from your textbook and at least one other supplemental source.

Answer 1

Extensive Burn

Burns is the defined that injuries that results from direct contact with or exposure to any chemical thermal or radiation source.The skin is the largest organ of the body,major fuctions of the skin is protection from the environment, sensory perception, vitamin production, excretion of water and some wastes, and regulation of body temperature. When the extensive skin loss or damage condition, bacteria are no longer prevented from invading, pain is produced (unless superficial sensory nerves are destroyed), and both fluid and heat are lost through the damaged area.

Etiology:

Chemical (strong acids ,alakali or organic compunds)

Thermal(hot liquids,steam)

Electrical

Radiation(uv)

Smoke and inhalations(carbon monoxide)

Burn injury severity classification:

Minor Injury Child Percent of (TBSA) Affected Moderate Injury Child Major Injury Child Depth of Burn Adult Adult Adult Partial Thickness First degree <50 <10 50-75 10-20 >75 >20 Second degree <15 <10 15-25 10-20 >25 >20 Full Thickness Third degree 2-10 2-10 >10 >10 *Irrespective of burn extent, injuries are classified as major when they involve areas of special importance, such as the eyes, ears, hands, feet, or genitals. Injuries are major when burns occur in conjunction with other major trauma (e.g., fractures) or inhalation injury. "TBSA, total body surface area.

Pathophysiology of the extensive burn:

STEPS:

Heat from the external source is conducted in to the skin →direct injury in the skin →

Destroys tissues →

At the susutained temperature of 54 to 60 degree celsius various cellular enzyme system and cellular system fails →

Sodium pottasium fails and cellular edema will occur→

Cell necrosis→

Cell damage(vasoactive substances released from the injured tissue.

Clinical Manifesations:

Weak pulse

Decreased platelet

Decreased cardiac output

Decreased blood preesure

Cardiovascular system alteration

Prolonged clotting and prothrombin time

Pulmonary alteration

Fluid and electrolyte changes

Renal,immunological,thermoregulatory,GI,psychological alterations

Diagnostic evaluations:

CBC

Physical examination

Na,K,Cl

Prothrombin time

History colllection

ABG analysis

Bleeding and clotting time

RBS,urea and creatinine,ECG,chest x-ray

2.CASE SCENARIO:

diaper dermatitis:

Increased wetness by urine and feaces makes skin more susceptible to damage by physical,chemical and ezymatic mechanisms.

Secondary infections:candila albicans(after 48-72 hours of chemical dermatitis),E.Coli,staphylococcus aures,Proteus mirabilies.

Risk Factors:

age between 8 to 10 months

babies are not kept clean and dry

increased wetness in diaper aera

infrequent chage of diaper

babies who have frequent stools

babies begin to eat solid foods

Preventions:

frequent changes of diaper

use cotton or super absorable diapers