BURNS: PAIN MANAGEMENT

Question 1

PAIN MANAGEMENT (7)

Answer 1

1. Establish ongoing monitoring of pain and effectiveness of pain treatment.
2. Avoid IM or subcutaneous injections.
3. Use intravenous opioid analgesics such as morphine sulfate, hydromorphone (Dilaudid), andfentanyl (Sublimaze). Anesthetics such as ketamine (Ketalar), pentobarbital sodium (Nembutal),and nitrous oxide also may be used.
4. Monitor for respiratory depression when using opioid analgesics.
5. The use of patient-controlled analgesia is appropriate for some clients. They help decrease painevel, and the client benefits from having a sense of control.
6. Administer pain medication prior to dressing changes or procedures.
7. Use nonpharmacologic methods for pain control, such as guided imagery, music therapy, andTherapeutic touch, to enhance the effects of analgesic medications and lead to more effective pain management.

Question 2

PREVENT INFECTION (9)

Answer 2

Prevent Infection

1. ■■ Follow standard precautions when performing wound care.
2. ■■ Restrict plants and flowers due to the risk of contact with Pseudomonas aeruginosa.
3. ■■ Restrict consumption of fresh fruits and vegetables.
4. ■■ Limit visitors.
5. ■■ Use reverse isolation if prescribed.
6. ■■ Monitor for manifestations of infection and report to provider.
7. ■■ Use client-designated equipment such as BP cuffs, thermometers.
8. ■■ Administer tetanus toxoid if indicated.
9. ■■ Administer antibiotics if infection present.

Question 3

NUTRITIONAL SUPPORT (6)

Answer 3

Nutritional Support

1. ■■ The client who has a large area of burn injury will be in a hypermetabolic and hypercatabolic
2. state. The client may need 5,000 calories per day.
3. ■■ Increase caloric intake to meet increased metabolic demands and prevent hypoglycemia.
4. ■■ Increase protein intake to prevent tissue breakdown and to promote healing.
5. ■■ Enteral therapy or total parenteral nutrition (TPN) may be necessary due to decreased
6. gastrointestinal motility and increased caloric needs.

Question 4

RESTORATION MOBILITY (7)

Answer 4

Restoration of Mobility

1. ■■ Maintain correct body alignment, splint extremities, and facilitate position changes to
2. prevent contractures.
3. ■■ Maintain active and passive range of motion.
4. ■■ Assist with ambulation as soon as the client is stable.
5. ■■ Apply pressure dressings to prevent contractures and scarring.
6. ■■ Monitor areas at high risk for pressure sores (heels, sacrum, back of head).

Question 5

Psychological Support of Client and Family

Answer 5

Psychological Support of Client and Family

1. ■■ Provide emotional support.
2. ■■ Assist with coping.