Homework Answers
Diagnosis: Chemical Burns
A burn is a physical injury, caused by heat, Caustic chemicals, cold, electricity or radiation. Chemical Burns are caused by Chemicals such as Acids, Bases, Metals, hair colouring agents etc.
Pathophysiology
Chemicals in come in contact with skin( spilling of chemicals)
?( leads to)
Damage to the tissues, Denaturing of proteins
?
Coagulation necrosis ( tissue death) or liquefaction necrosis, vascular damage
?
Formation of a coagulum that will limt the further penetration of acid the skin. , structural changes in skin and mucosa, inflammation, pain.
Health promotion and disease prevention
* Avoid unnecessary use of chemicals and mixing of chemicals with other chemicals.
* Purchase and store chemicals properly in powerful containers with labelling
* Keep chemicals out of reach of infants and children
* Use protective clothing and gloves when you use chemicals.
* Store the chemicals away from drinks and foods.
Risk factors
* people, handling acids or other chemicals
* Infants, people with disabilities and elderly adults because of improper handling.
Expected findings
* Dead or blackened skin due to chemical burns
* pain and numbness or irritation, burning in the affected site
* visual impairment ( if chemicals come in contact with eyes)
* In case of ingestion: shortness of breath, head ache, dizziness, coughing, low blood pressure.
Diagnostic procedures
*Direct examination of the site
*Endoscopy ( in case of ingestion)
* Liver and Kidney function test
* Radiographic studies for upright chest ( to know the presence of any perforation)
* Ultrasonography to detect the locations ( ingestion of batteries)
Laboratory findings
* Complete blood count
*Platelet, electrolyte, magnesium and calcium
* Liver and kidney function test
Complications
Severe chemical burns leads to complications such as:
* loss of limb or limbs
* disfigurement or deformity
* Scarring
* Infection, tissue or muscle damage
* Psychological complications like depression, nightmares
Patient centred Care
Nursing Care:
First aid - Remove the chemical from skin under running water for a 15 minutes
Remove any jewellery or clothing that soiled with the chemicals.
Therapeutic procedures:
* Debridement: The removal of dead or damaged or infected tissue to enhance healing process of remaining healthy tissues.
* Intravenous infusion of IV fluids to treat fluid and electrolite imbalance.
* Skin grafting : Process of attaching healthy skin to the burm wound from another part of the body.
Medications
Antibiotics: To prevent or treat infection
Anti - itch medications
Analgesics: Over the counter medications for pain .eg: Acetaminophen
Client education:
* instruct the client to keep the site clean
* Avoid scratching of the area
* wear loose fitting clothes
* protect the wound from sun
Interprofessional care:
Management of burn and rehabilitation should involve the different professionals for various management interventions such as:
* Cosmetic surgery
* Counselling ( to provide psychological support and to increase self esteem of the client) by a trained Counsellor
* Occupational therapy : to develop skills withthe help of a occupational therapist.
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