A patient with a first-degree burn on the forearm reports mild pain. Which of the following interventions should the nurse suggest to provide immediate relief?

A) Apply a cool compress to the affected area

B) Cover the burn with a thick layer of petroleum jelly

C) Expose the burn to direct sunlight for drying

D) Apply ice directly to the burn for 20 minutes

Based on the initial assessment findings, what is the most appropriate first step in managing the patient's first-degree burn?

C) Apply cool compresses to the affected area.

A) Apply an occlusive dressing to the burn.

B) Administer oral antibiotics to prevent infection.

C) Apply cool compresses to the affected area.

D) Perform debridement of the burn.

Which of the following actions should the nurse reinforce as part of the patient's ongoing burn care plan to prevent infection?

C) Protect the healing skin from sun exposure

A) Apply a thick layer of antibiotic ointment daily

B) Keep the burn area exposed to air as much as possible

C) Protect the healing skin from sun exposure

D) Use warm compresses to soothe the burn site

Which of the following is the most appropriate nursing action to reinforce during the follow-up visit for a patient with a healing burn?

C) Remind the patient to continue using cool compresses and keep the area clean and dry.

A) Encourage the patient to apply a thick layer of antibiotic ointment.

B) Advise the patient to keep the burn site exposed to air for faster healing.

C) Remind the patient to continue using cool compresses and keep the area clean and dry.

D) Suggest the patient discontinue the use of antibiotic ointment since the burn is improving.

During a follow-up appointment, a nurse notes that a patient's burn site has improved with only slight residual erythema and no blistering or open areas. The patient reports minimal discomfort and stable vital signs. What is the most appropriate nursing intervention to support continued healing and prevent complications?

C) Suggest using a gentle, fragrance-free moisturizer once the skin is fully healed

A) Recommend applying an antibiotic ointment daily

B) Advise discontinuing all topical treatments

C) Suggest using a gentle, fragrance-free moisturizer once the skin is fully healed

D) Encourage the patient to expose the burn to direct sunlight to promote healing

What is the primary reason for advising the patient to use a gentle, fragrance-free moisturizer on the healed burn site?

B) To prevent skin dryness and potential scarring

A) To promote faster wound healing

B) To prevent skin dryness and potential scarring

C) To protect the skin from sun damage

D) To reduce the risk of infection

Which factor was most likely crucial in the patient's rapid and positive recovery from the burn injury?

B) Adherence to the prescribed care regimen

A) Regular application of a gentle moisturizer

B) Adherence to the prescribed care regimen

C) Consuming a diet high in vitamins C and E

D) Keeping the affected area covered at all times

What is the primary reason the nurse advises the patient to incorporate a balanced diet rich in vitamins C and E during her recovery from a burn injury?

B) To promote skin repair and regeneration

A) To enhance the body's immune response and prevent infection

B) To promote skin repair and regeneration

C) To increase the absorption of topical medications

D) To reduce the risk of developing hypertension

What is the primary reason for advising the patient to use sunscreen on healing skin?

B) To protect against UV-induced skin damage

A) To enhance vitamin D absorption

B) To protect against UV-induced skin damage

C) To prevent the moisturizer from evaporating

D) To improve the skin's appearance

During a follow-up visit, a nurse assesses a patient's skin healing process after an injury. Which of the following findings indicates that the patient's skin is healing well?

B) Healthy pink tone with minimal dryness

A) Presence of erythema and swelling

B) Healthy pink tone with minimal dryness

C) Increased warmth and tenderness

burns - Nursing Case Study

Pathophysiology

• Primary mechanism: Burns cause damage to skin layers, leading to direct cellular injury and death. This disrupts the protective barrier of the skin, increasing the risk of infection and fluid loss.

• Secondary mechanism: The injury triggers an inflammatory response, resulting in increased blood flow and vascular permeability. This can lead to swelling and further tissue damage due to the release of inflammatory mediators.

• Key complication: Minor complications include localized pain and potential for infection at the burn site, as the compromised skin is less effective at preventing bacterial entry.

Patient Profile

Demographics:

25-year-old female, chef

History:

• Key past medical history: No significant past medical history

• Current medications: None

• Allergies: No known drug allergies

Current Presentation:

• Chief complaint: Minor burn on left forearm

• Key symptoms: Redness and mild pain; no blistering or peeling

• Vital signs: Temperature 98.6°F, Heart rate 72 bpm, Blood pressure 118/76 mmHg, Respiratory rate 16 breaths per minute, Oxygen saturation 99% on room air

Section 1

Initial assessment findings:

Upon initial assessment, the nurse notes that the burn on the patient's left forearm is approximately 3 cm in diameter, with well-defined borders. The skin is erythematous, indicating a superficial burn, commonly known as a first-degree burn. The patient reports mild pain, rated as 3 out of 10 on the pain scale, which is relieved slightly with cool compresses. There is no evidence of blistering or open wounds, and the surrounding skin appears intact and unremarkable. Capillary refill time in the affected area is less than 2 seconds, indicating adequate perfusion. The patient denies any loss of sensation in the area, and there are no signs of edema or infection, such as pus or increased warmth.

The nurse proceeds with further assessment to ensure there are no other areas of concern. A head-to-toe examination reveals no additional injuries or abnormalities. The patient is alert and oriented, and her vital signs remain stable: temperature 98.6°F, heart rate 72 bpm, blood pressure 118/76 mmHg, respiratory rate 16 breaths per minute, and oxygen saturation 99% on room air. The nurse educates the patient on the importance of keeping the area clean and dry to prevent infection, as well as instructing her on signs of infection to watch for, such as increased redness, swelling, or pain. The patient is advised to avoid exposing the burn to direct sunlight and to apply a thin layer of antibiotic ointment as a precautionary measure. These findings and education provide a foundation for monitoring the patient's progress and response to treatment.

Section 2

Response to Interventions:

Following the initial education and application of a thin layer of antibiotic ointment, the patient returns for a follow-up visit two days later. During this visit, the nurse reassesses the burn site to monitor the patient's response to the interventions. The patient reports that the pain has decreased, now rating it as 1 out of 10, and she has been diligent in applying cool compresses and keeping the area clean and dry as instructed. Upon examination, the erythema of the burn has lessened, with the borders appearing slightly faded. There is no evidence of infection, as the skin remains intact without any signs of pus, increased warmth, or significant swelling. The patient has adhered to recommendations to avoid sun exposure, and there are no new areas of irritation or discoloration.

Vital signs are reassessed to ensure overall stability: temperature is 98.7°F, heart rate is 70 bpm, blood pressure is 116/74 mmHg, respiratory rate is 16 breaths per minute, and oxygen saturation remains at 99% on room air. The patient expresses relief that the burn is healing well and asks about the continued care plan. The nurse reinforces the importance of ongoing care, including the application of ointment and protection of the healing skin from potential irritants or trauma. Additionally, the nurse reminds the patient to stay vigilant for any late-onset signs of infection and to follow up if any changes occur.

As the patient prepares to leave, the nurse and patient discuss the next steps, including when to seek further medical attention if necessary. The patient is encouraged by the positive progress and feels confident in managing the remaining healing process. This successful response to interventions reassures both the patient and the healthcare team, allowing for a smooth continuation of recovery.

Section 3

A week later, the patient returns for another follow-up appointment. During the initial assessment, the nurse notes even further improvement in the condition of the burn site. The skin appears healthier, with only slight residual erythema and no blistering or open areas. The patient reports feeling minimal discomfort, rating it as 0 out of 10, and mentions being able to return to most of her usual activities without any hindrance. Her diligence in applying the antibiotic ointment and avoiding any potential irritants has contributed to the burn's continued positive healing trajectory.

The nurse conducts a thorough reassessment, finding the patient's vital signs remain stable: temperature is 98.6°F, heart rate is 72 bpm, blood pressure is 118/76 mmHg, respiratory rate is 18 breaths per minute, and oxygen saturation is consistently at 98% on room air. The nurse also checks for any signs of delayed infection or complications, but the skin remains intact, with no signs of increased warmth, swelling, or unusual coloration. The patient is advised to continue her current care regimen and is reassured that these findings are consistent with a normal healing process.

Before concluding the visit, the nurse and patient discuss the importance of maintaining skin hydration to prevent dryness and the potential for scarring. The nurse recommends a gentle, fragrance-free moisturizer to apply once the skin is fully healed. The patient expresses satisfaction with the care received and feels confident in managing her recovery. The healthcare team remains available for any further questions or concerns, emphasizing a patient-centered approach that empowers the patient in her healing journey.

Section 4

A week later, the patient arrives for another follow-up appointment, her spirits high and confidence in her recovery growing. During this visit, the nurse performs a detailed initial assessment, noting that the burn site continues to show remarkable improvement. The skin has regained much of its natural texture and elasticity, with only faint traces of erythema visible. The patient reports no pain, maintaining a 0 out of 10 on the pain scale, and has resumed all usual activities without limitation. She has adhered strictly to her care regimen, including the application of antibiotic ointment and avoidance of irritants, which the nurse acknowledges as a key factor in her rapid and positive recovery.

The nurse also performs a routine check of the patient's vital signs, which remain stable: temperature is 98.7°F, heart rate is 70 bpm, blood pressure is 116/74 mmHg, respiratory rate is 16 breaths per minute, and oxygen saturation is 99% on room air. No signs of infection are present; the skin is intact and free from swelling or unusual coloration. The patient is advised to continue her current regimen and is reminded of the importance of using a gentle moisturizer once the skin is fully healed to prevent dryness and potential scarring.

To further support her recovery, the nurse suggests that the patient incorporate a balanced diet rich in vitamins C and E, known for their roles in skin repair and regeneration. The patient expresses gratitude for the comprehensive care and education provided, feeling empowered to manage her recovery effectively. The healthcare team reiterates their availability for any future questions or concerns, emphasizing the importance of maintaining open communication to ensure continued progress in her healing journey.

Section 5

During the follow-up visit, the nurse conducts a thorough assessment, paying close attention to any changes in the patient's condition. As the patient has been adhering to her care plan diligently, the nurse anticipates continued improvement. The patient's skin is examined meticulously, revealing that the erythema has nearly resolved, with the area now exhibiting a healthy pink tone and minimal dryness. The patient is encouraged to gently massage the area with a vitamin E-enriched moisturizer to enhance skin elasticity and further prevent any potential scarring.

In addition to the physical examination, the nurse reviews the results of recent blood work, which were ordered to monitor the patient’s nutritional status and overall health. The lab results indicate normal ranges for white blood cell count, confirming there is no underlying infection. The patient's levels of vitamins C and E are optimal, reflecting her commitment to a balanced diet as advised. These findings reassure both the patient and the nurse that the recovery process is on track, with no evidence of complications.

Before concluding the appointment, the nurse discusses the importance of gradually reintroducing sun exposure to the healing skin, emphasizing the use of sunscreen to protect against UV rays. The patient is advised to continue her current regimen and is scheduled for a final follow-up appointment in one month. The nurse encourages the patient to reach out with any questions or concerns, reinforcing the support available throughout her recovery journey. Confident in her progress, the patient leaves the clinic feeling positive and well-guided in her continued healing process.