Diagnosis Case Study Essay -- Health Care

Identify possible nursing diagnoses that Karen may have and provide a rationale for your choice: A nursing diagnosis that would be attributed to the patient, Karen in the case study would be risk of deficient fluid volume. Karen’s slightly elevated pulse and respirations and additionally the assessment findings of mild oedema and blister formation show that there is a movement of body fluid into the second and third interstitial spacing. Brown and Edwards (2008) states this is caused by increased capillary permeability. Water, sodium and plasma protein move into the intestinal spacing and surrounding tissue. Furthermore Karen states that she has a headache, feels nauseas and chilled after being over exposed to the sun. Karen has a temperature of 38.5 and an abundant of redness to her body surface after prolonged exposure. Over exposure to ultra violet rays can cause thermal burns which leads to increased fluid loss via evaporation from the injured skin. Assessing the fluid loss, perfusion and oxygenation status, and evaluating the need for fluid and electrolyte replacem ent that is lost, through fluid and protein shifts can aid in the restoration of intravascular volume. Another expected nursing diagnosis is acute pain. The sudden onset of pain is a result of the nociceptive tissue damage and the nursing treatment required for the injury tissue. Careful assessment of the wound and surrounding tissue can help determine the level of injury sustained. The pain is variable and cannot be reliably predicted by clinical assessment of the patient. ‘Burn patients experience two kinds of pain continuous background pain, which occurs during the course of the day and night. Secondly, a treatment induced pain which is related to ambulation,... ...dical- surgical nursing, Assessment and management of clinical problems, 2nd edn, Elsevier Australia, Chatswood. Funnell, R, Koutoukidis, G & Lawrence, K (2009) Tabbner’s nursing care, 5th edn, Elsevier, Chatswood. Greenfield, E (2010) The pivotal role of nursing personnel in burn care, Indian Journal of plastic surgery Vol. 43, No. 3, pp.94-100, Viewed online 17th March 2010. http://www.ijps.org/article.asp?issn=09700358;year=2010;volume=43;issue=3;spage=94;epage=100;aulast=Greenfield. Patterson, R, Hoflund, H, Espey, K & Sharar, S(n.d.)Pain management, Pain Control - The International society for burn injuries, Viewed online 17th March 2012 http://www.worldburn.org/documents/painmanage.pdf. Sholtis-Bunner, L, Smeltzer, S, Bare, B Hinkle, J, Cheever, K 2009, Brunner and Suddarth's Textbook of Medical Surgical Nursing, 12thedn, Lippincott Williams & Wilkins,