NUR 417 BURN CASE STUDY (PSLO) QUESTIONS AND
ANSWERS
A 69 year old female patient, J.L., is admitted through the ED after she was burned
by the explosion of a paint can thrown into her outdoor burn pile. She is awake
and oriented but agitated and unable to report about the accident. She is reporting
severe pain in her face, neck and right arm. Her voice is raspy and she says she is
cold and shivering. Hair on her head and arms are singed. She has areas of redness,
waxiness and blisters covering her face, anterior neck, all of her right arm, chest,
abdomen and anterior surface of her left arm. The patient’s weight is 176 pounds.
VS: BP (thigh) 110/52, HR 132, RR 36. Medical history includes MI seven years
ago followed by chronic heart failure. Meds: Accupril 20mg PO QD, Lasix 20mg
PO QD, Pravachol 40mg PO QD.
1. For each of the following nursing interventions, write a number in the
blank to indicate the appropriate order of the tasks.
a. Administer IV Morphine _6
b. Administer IV fluids 5
c. Administer 100% humidified O2 1
d. Administer prophylactic _9
tetanus toxoid
e. Establish IV access 2
f. Initiate appropriate wound care 8
g. Insert indwelling urinary catheter 7
h. Prepare for endotracheal intubation 3
i. Estimate body surface area burned 4
2. As J.L. is in the ED the nurse is closely assessing each of the following.
What abnormalities in each area would be of high concern for the nurse?
Why?
a. Urinary output- Urine output less than 0.5 mL/kg/hr would be a
concern which can lead to hyper/hypovolemia and injury to the
kidneys
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https://www.coursehero.com/file/181838546/NUR-417-Burn-Case-Study-PSLO-2docx/
, b. Upper airway- Upper airway injury due to the inhalation of hot air,
steam or smoke. Redness and edema can occlude the airway
preventing breathing and circulation which may be an immediate
sign for ET tube placement. Immediate intubation when signs of
injury to the upper airway will prevent more invasive interventions
and respiratory problems
c. Lung sounds- Hoarseness, wheezing, SOB, crackles are
abnormalities that would be a high concern. Hoarseness, wheezing
and SOB can signify the need for intubation. Crackles heard over
the lungs may be an early sign of heart failure or pulmonary edema
which can mean that the fluids being given may be overloading the
patient
d. Core body temperature- Increased body temperature above 100 or a
drastic increase or decrease in core temperature. This can indicate
infection that may lead to sepsis or shock
3. The physician orders fluid replacement according the Parkland formula.
J.L. reports that she is 135 pounds. Figure the goal amount of Lactated
Ringer’s solution to be infused for J.L. in the first 24 hours and again for
the first 8 hours. 3,500mL
4. J.L.’s husband sees the IV fluid running really fast and asks why J.L. needs
so much so fast. What would you say to him?
a. The greatest threat to JL right now is hypovolemic shock. Massive
shifts of fluid within the body occur as soon as 20 minutes after the
patient experiences a burn. Our main goal is to prevent the adverse
reactions that may occur due to this fluid shift. It may seem like a lot
initially, but it is based on JL body surface area that was burned and
her weight. The amount of fluid being given to her is specific just for
her situation and allows us to prevent further complications down the
line.
This study source was downloaded by 100000903071754 from CourseHero.com on 01-09-2026 11:22:41 GMT -06:00
https://www.coursehero.com/file/181838546/NUR-417-Burn-Case-Study-PSLO-2docx/
ANSWERS
A 69 year old female patient, J.L., is admitted through the ED after she was burned
by the explosion of a paint can thrown into her outdoor burn pile. She is awake
and oriented but agitated and unable to report about the accident. She is reporting
severe pain in her face, neck and right arm. Her voice is raspy and she says she is
cold and shivering. Hair on her head and arms are singed. She has areas of redness,
waxiness and blisters covering her face, anterior neck, all of her right arm, chest,
abdomen and anterior surface of her left arm. The patient’s weight is 176 pounds.
VS: BP (thigh) 110/52, HR 132, RR 36. Medical history includes MI seven years
ago followed by chronic heart failure. Meds: Accupril 20mg PO QD, Lasix 20mg
PO QD, Pravachol 40mg PO QD.
1. For each of the following nursing interventions, write a number in the
blank to indicate the appropriate order of the tasks.
a. Administer IV Morphine _6
b. Administer IV fluids 5
c. Administer 100% humidified O2 1
d. Administer prophylactic _9
tetanus toxoid
e. Establish IV access 2
f. Initiate appropriate wound care 8
g. Insert indwelling urinary catheter 7
h. Prepare for endotracheal intubation 3
i. Estimate body surface area burned 4
2. As J.L. is in the ED the nurse is closely assessing each of the following.
What abnormalities in each area would be of high concern for the nurse?
Why?
a. Urinary output- Urine output less than 0.5 mL/kg/hr would be a
concern which can lead to hyper/hypovolemia and injury to the
kidneys
This study source was downloaded by 100000903071754 from CourseHero.com on 01-09-2026 11:22:41 GMT -06:00
https://www.coursehero.com/file/181838546/NUR-417-Burn-Case-Study-PSLO-2docx/
, b. Upper airway- Upper airway injury due to the inhalation of hot air,
steam or smoke. Redness and edema can occlude the airway
preventing breathing and circulation which may be an immediate
sign for ET tube placement. Immediate intubation when signs of
injury to the upper airway will prevent more invasive interventions
and respiratory problems
c. Lung sounds- Hoarseness, wheezing, SOB, crackles are
abnormalities that would be a high concern. Hoarseness, wheezing
and SOB can signify the need for intubation. Crackles heard over
the lungs may be an early sign of heart failure or pulmonary edema
which can mean that the fluids being given may be overloading the
patient
d. Core body temperature- Increased body temperature above 100 or a
drastic increase or decrease in core temperature. This can indicate
infection that may lead to sepsis or shock
3. The physician orders fluid replacement according the Parkland formula.
J.L. reports that she is 135 pounds. Figure the goal amount of Lactated
Ringer’s solution to be infused for J.L. in the first 24 hours and again for
the first 8 hours. 3,500mL
4. J.L.’s husband sees the IV fluid running really fast and asks why J.L. needs
so much so fast. What would you say to him?
a. The greatest threat to JL right now is hypovolemic shock. Massive
shifts of fluid within the body occur as soon as 20 minutes after the
patient experiences a burn. Our main goal is to prevent the adverse
reactions that may occur due to this fluid shift. It may seem like a lot
initially, but it is based on JL body surface area that was burned and
her weight. The amount of fluid being given to her is specific just for
her situation and allows us to prevent further complications down the
line.
This study source was downloaded by 100000903071754 from CourseHero.com on 01-09-2026 11:22:41 GMT -06:00
https://www.coursehero.com/file/181838546/NUR-417-Burn-Case-Study-PSLO-2docx/
