April Showers was planting her May flowers near her propane tank, when a spark o

Question

April Showers was planting her May flowers near her propane tank, when a spark of static electricity caused an explosion. She suffered burns, multiple abrasions and lacerations, and a compound fracture of her humerus. She was transported to the emergency room. Her evaluation indicated the following:

REVIEW OF SYSTEMS:

Integument: Second degree burns are located on the anterior trunk from superior pectoral areas extending to the inguinal area bilaterally and pubic area. Third degrees burns are located on the left posterior arm from the axilla to the carpal area. She has abrasions of his right sural region. She has a laceration of her left calf extending from the inferior popliteal area to the plantar surface of her foot. There are multiple contusions of the lumbar and thoracic area.

Musculoskeletal: X-rays revealed a compound fracture of the right humerus at the mid diaphysis by the deltoid tuberosity.

Nervous: Pupil reaction is sluggish. The patient has a headache. She has neck pain as well. She is unable to extend her wrist due to muscle weakness. There is numbness of the posterior thumb and first finger.

Endocrine: Denies diabetes or thyroid problems.

Cardiovascular: Denies chest pain. Heart sounds normal. Blood pressure is 150/90. Heart rate is 140 beats per minute.

Respiratory: Lungs clear to auscultation. No crepitus noted. Respiratory rate is 30.

Digestive: Bowel sounds normal. Denies any problems.

Urinary: Patient denies any problems.

Lab Results: Sodium             180 mEq/L   High

       Blood Urea Nitrogen   40 mg/dl   High

Answer the following questions in the form of an essay or each answer separately. Sources must be cited in MLA format. WIKIpedia and WEB MD are not acceptable sources. At least one source must be a refereed allied health journal for current scientific information. If you are not sure what this is, consult with the library staff.

1.)In layman’s terms, describe the location of the injuries. (2)

2.)With second degree burns, what layers of the skin and structures are injured? What functions of the skin would be impaired? (3)

3.)Would a second degree burn be painful, why or why not? What about a third degree burn? (2)

4.)How extensive are April’s burns? Compute the percentage of second degree and third degree burns using the rule of nines. (3)

5.)Name two other body systems whose functions would be impaired by these extensive burns and why? (3)

6.)What do the two lab tests provided test for and why would they be abnormal in this case? (2)

7. )Define a laceration. (1)

8.)Define auscultation. (1)

9.) Are the patient’s vital signs – heart rate, blood pressure and respiratory rate -normal? If not name a possible cause of this based upon her physical condition. (3) The heart rate is tachycardia which means fast for anything over 100.

10.) Define what a compound fracture is. (1)

11.)Describe the phases of bone healing. (3)

12.)The patient has been immobilized in a sling for 6 weeks with the elbow bent to 90 degrees. They are allowed to move their wrist and fingers. They are now out of the sling. What are the movements of the shoulder joint, elbow joint and forearm? (4)What are the structural and functional classifications of the shoulder and elbow joints? (2)

13.)You have been asked to develop a home exercise program for this patient to attain full motion of the shoulder and elbow. Describe 2 exercises for each joint to attain this goal. (4)

14.)The patient is now ready to begin strengthening the muscles of the shoulder movements. Name a muscle for each movement of the shoulder and an exercise that would strengthen that muscle. (6)

Explanation / Answer

Ans-1- in a leyman terms the location of injury are head and face.

Ans-2 in second degree burn internal layer mesoderm and ectodermal layer are burned and blister appears.

Ans-3 second degree burn are painful but third degree burn are most painful but in some cases there is no pain in third degree burn because of nerve damage.

Resorce- j.p. modi ( medical jurisprudence and toxicology)

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