Hala 29 year-old female who was cooking a meal for her husband. She was frying chicken when she was adding rice to the chicken, the grease of the chicken caught fire. She panicked, grabbed the boiling pasta water on the stove, and dumped it on the grease fire. The fire exploded into a big fire ball, burning Hala’s face and hair, and catching Hala’s shirt on fire.

Luckily, Hala’s husband Mohammed walked in right after the explosion. Grabbing Hala, he rolled her on the floor, quickly extinguishing the flames. He grabbed some baking soda, threw it on the fire to extinguish the flames, and called 101.

The 101 dispatcher sent emergency response personnel, including EMTs, and firefighters to the site. Hala was still conscious and in a great deal of pain. Keeping Mohammed on the phone, the dispatcher asked Mohammed to gently turn Hala on to her back and tilt her head to one side. He then told Mohammed to elevate her legs to prevent shock.

Firefighters and paramedics arrived quickly on the scene. Emergency responders placed Anna on 100% oxygen, put her in a neck brace as a precautionary measure, carefully moved her on a back board, and loaded her into the ambulance. During transport, paramedics started an IV and began administering Lactated Ringer's solution to replace lost fluid volume. They also cut away her burnt clothing and placed a light blanket over her to preserve her body temperature.

1. What type of burn Hala’s sustained? (1 point)

Answer: ____________________________________________________

Hala was transported to ER. Upon her arrival to ER the patient presented with tachypnea and tachycardia but remained conscious. Vital signs were taken and were as follows: Temperature: 38.5 C, Blood Pressure: 85/50 mmHg, Pulse: 130 bpm, Respirations: 24 breaths/minute.

2. Explain patient’s Fever, Hypotension and Tachycardia? (6 points)

Fever: _______________________________________________

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Hypotension: _________________________________________

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Tachycardia: _________________________________________

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The extent of the burns was assessed using the "Rule of Nines."Hala had burns on the anterior head and neck, anterior and posterior of both arms and the anterior trunk.

3. Using the rule of nines, what is the total Burn body's surface area? Using parkland formula to replace fluid? (4 points)

Answer: ____________________________________________________

The depth of the burns were also assessed. Full-thickness or third-degree burns were present on the right shoulder, upper anterior right arm, and part of the anterior trunk. Second-degree burns with blistering were present on the remaining burn areas.

4. What is the danger of a large burn around the chest wall? (2 points)

Answer: _______________________________________________

The patient was started on an IV drip of 3-5 mg/10 minutes of morphine for pain. The head was elevated to maintain an open airway but stridor was noted. Hala

was intubated and placed on mechanical ventilation to maintain an open airway. A Foley catheter was inserted to monitor urinary output for strict I&O.

1. What has caused stridor? (2 points)

Answer: _______________________________________________

Hala's wounds were gently cleaned and wrapped with a silver, antimicrobial dressing and she was started on IV antibiotics.

2. What is the rational? (2 points)

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She was taken to the burn ICU. Her RN inserts an NG (nasogastric) tube for feedings. Enteral feedings will begin as soon as Hala is hemodynamically stable.

3. What is the nutritional needs for hala ? (3 points)

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4. In planning care for Hala. List 5 nursing interventions (please Prioritize) (5 points)
   1. ________________________________________________________
   2. ________________________________________________________
   3. ________________________________________________________
   4. ________________________________________________________
   5. ________________________________________________________