FIGURE 7.

PATHOPHYSIOLOGY DIAGRAM OF A 35-YEAR OLD MALE PATIENT WITH ELECTRICAL BURN INJURY OF 66% TBSA

Electric shock with High Voltage

Acute Injury to System Intact nerve sensors Diminished tactile sensors Full thickness Burn in Lower extremities Destruction of capillaries Increased capillary permeability Sodium, water and protein shift from intravascular to interstitial spaces
Imbalanced Nutrition: Less than Body Requirements

Deep and Superficial Partial Thickness Burn wounds Disruption of electrical conduction system of heart

Acute Pain Decreased Sensation

Dolcet Tab and Tramadol

Cell lysis

Rhabdomyolosis Loss of 66% epidermis (Skin Breakdown) Increased insensible water and electrolyte loss Impaired Skin Integrity Possible hemoglobin/ myoglobin in urine

Blood Chem: Hyperkalemia Urinalysis: No RBC or Myoglobin found in urine Urine yellowish in color

Possible Dysrhythmia

Circumferential burn

Destruction of nerve sensors No pain sensation Blood Chem: Decreased Serum Albumin

Eschar formation

Thermoregulation problems

Inflammatory response

Decreased capacity to expand

Impaired Physical Mobility

Increased potential for dehydration Decreased Circulating Blood Volume

Chills

Impaired immune response

Risk for Infection

Cefazolin

Increased muscle circumference

Decreased oncotic pressure

Decreased space within the fascia Edema Formation Scrotal edema

Increased concentration of RBCs

Oliguria

Culture: Enterobacter species in wounds

Compartment Syndrome

Increased Blood viscosity

Burn Shock

Blood Chem: Hyponatremia

Fluid Volume Deficit

Decreased lumen size of arteries Compression of peripheral nerve

Decreased lumen size of veins

Venous pooling

Massive stress response, sympathetic nervous response activation

Adrenal corticoid hormones and cathecolamine release

Tachycardia

Weak peripheral pulses Increased capillary refill time Cyanosis of foot, Skin cool to touch Ineffective Tissue Perfusion Decreased Cardiac Output

Peripheral vasoconstriction

Risk of Curlings Ulcer

Increased Metabolism After Burn Shock Resolves

Paresthesia

Increased Afterload

Omeprazole

Decreased GI blood flow Decreased Renal blood flow Tissue damage Tissue necrosis

Decreased blood flow to organ systems

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