Samamtha OSCE Flashcards
To which class does silver sulfadiazine belong?
Sulphonamides
Please outline how silver sulfadiazine works?
This silver ion binds with the DNA of the organism, releasing the sulphonamide which interferes with the intermediary metabolic pathway of the microbe
What side effects of silver sulfadiazine may Samantha expierence?
Leukopenia. Skin reactions
What is silver sulfadiazine?
It’s an antibiotic cream
Why does Samantha need silver sulfadiazine?
Samantha’s scalds means she is more likely to get an infection. This is an antibiotic cream that will help to reduce the chances of an infection.
How does the silver sulphadiazine work?
Silver sulfadiazine works by killing off the germs before they get into Samantha’s body, so preventing infection rather than having to treat infection.
How often will Samantha need the silver sulphadiazine?
The cream will be applied once a day, probably mid morning and then covered with a dressing
So if Samantha’s burns start to clear up shoulr we stop applying the silver sulphadiazine?
No the cream will need to be applied until the skin has completely healed or there is a risk of infection
What happens if he scalds get worse, not better?
Samantha will be reviewed daily by the healthcare team and if there is any deterioration in the wound we have many other options to help her recover
Are there any side effects associated with taking silver sulphadiazine that I should look out for?
Most children do not have any problem with the cream. Very occasionally a child may have an issue with some of their white blood cells or a reaction on their skin, but these are rare.
Is there anything else I could do to help Samantha’s scalds heal?
Ensure the wound is clean and dry
Ensure the dressings are clean and dry
Encourage Samantha not to touch/scratch the area
Encourage Samantha to rest to encourage healing
Monitor for increased redness and discharge in the wound. If noted, inform medical staff immediately
If Samantha develops a higher than normal temperature inform medical staff immediately
From the history and assessment outline four physiological concerns you have for Samantha and relate them to the Pathophysiology of thermal injury
Concern1:
Samantha is in significant pain due to scalds
Samantha has a extreme temperature and burns can damage the epidermis, dermis and then the subcutaneous layer and potentially could damage the muscle exposing nerve endings to the air causing nerve irritation and pain.
From the history and assessment outline four physiological concerns you have for Samantha and relate them to the Pathophysiology of thermal injury
Concern 2:
Samantha has an open wound, so is at risk of infection
Skin is a protective barrier to keep microbes out of the body. Children’s skin is thinner than adults, so there is an increased risk of damage.
The scald occurs then the skin is damaged which results in a increased opportunity for microbes to enter the body
From the history and assessment outline four physiological concerns you have for Samantha and relate them to the Pathophysiology of thermal injury
Concern 3:
Samantha has blisters developing in the wound
The epidermal and dermal layers of skin start to produce serum, plasma and blood which may fill the gaps which cause blisters
From the history and assessment outline four physiological concerns you have for Samantha and relate them to the Pathophysiology of thermal injury
Concern 4:
Tachypnoea, tachycardia and hypertension
Could be a response to pain, fear or there could be a systemic problem
Name one concern relating to Samantha’s mental well-being
Samantha is very anxious and stressed and needs support
Explain the process you would follow in preparation for prioritising care and writing a plan of care
Well it’s the nursing process:
I’d review Samantha’s history
Then review the assessment and clinical observations and decide which are out with acceptable limits
Decide the ADLs with which Samantha needs support
Consider priority of importance of Samantha’s needs
Write the care plan, ensuring each element is SMART
Ensure evaluation date is set
For each of the five priorities of care identified what actions will you take to alleviate them?
Concern 1: Samantha is in a significant amount of pain due to scalds
Assess pain and administer analgesia as prescribed and evaluate the effect
For each of the five priorities of care identified what actions will you take to alleviate them?
Concern 2: Samantha has an open wound, so is at risk of infection
Clean, dry and dress the would and apply antibiotic cream as prescribed to minimise risk of infection
For each of the five priorities of care identified what actions will you take to alleviate them?
Concern 3: Samantha has blisters developing in the wound
Leave blisters intact unless advised by medical staff to do so. Clean, dry and dress the area, applying antibiotic cream as prescribed
For each of the five priorities of care identified what actions will you take to alleviate them?
Concern 4: Tachypnoea, tachycardia, hypertension
Administer analgesia as prescribed then re-check vital signs once pain settled. If still elevated, escalate.
For each of the five priorities of care identified what actions will you take to alleviate them?
Concern 5: Samantha is very anxious and stressed and needs support
Build a therapeutic relationship with Samantha and mum to reduce anxiety
Of those 5 priorities of care, which three are the most urgent?
Samantha is in significant pain due to scalds
Samantha has an open wound, so is at risk of an infection
Samantha is very anxious and stressed so needs support
