50-year-old female patient works in a factory

50-year-old female patient works in a factory where an explosion occurs, arrives with 2nd and 3rd degree burns, is received in the emergency room by paramedics 2 hours after the explosion, weighs 187 lbs, patient receives R/L lowering to 200ml/hr morphine 10mg IV was administered, orally intubated endotracheal tube 7.5 connected to mechanical ventilator parameters A/C mode, Peep 7, Rate 20, patient with pneumothorax, atelectasis and hypovolemic shock, arterial blood gases (ABG’s) PH 7.20, PaCO2- 54, PaO2- 87, HCO3- 35, Sat- 85%, laboratories CBC Hgb 6.0 gm/dl, Hct 19.3%, Wbc 20,000/mcL, Platelets 150,000/dl, BMP Bun 27 mg/dL, Creat 1.5mg/dl, Na+ 130mEq/L, K+ 3.4 mEq/L, Mg 1.5 mg/dl, Type and Group A+, vital signs taken upon admission BP- 160/95 mm/Hg, P- 119 L/min, R-27 R/min, Temp-37.8ºC, procedures performed Escharotomy. Medications: Vancomycin 1gm IV every 12hrs, versed 50mg 3n 100nss down to 4ml/hr, silvadene apply to skin twice up to date. NANDA 00047 Risk of deterioration of skin integrity 1. Extract the objective estimate and the subjective estimate. 2. Estimate the personal, interpersonal, social aspect of the client according to Imogene M. King’s theory. 3. Need interfered according to Maslow’s pyramid. 4. Describe nursing interventions 5. Describe problem and etiology 6. Nursing orders 7. Identify the reason for performing nursing interventions 8. Evaluate and show if the expected results were achieved

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