Page 2440 - Saunders Comprehensive Review For NCLEX-RN

e. Provide a diet high in protein,
carbohydrates, fats, and vitamins, with
major burns requiring more than 5000
calories daily.
f. Monitor calorie intake and daily
weights.

I. Management of the burn injury: Acute phase (see Table 69-

7)
1. Continue with protective isolation techniques.
2. Provide wound care as prescribed and prepare for
wound closure.
3. Provide pain management.
4. Provide adequate nutrition as prescribed.
5. Prepare the client for rehabilitation.

J. Circulatory compromise treatments

1. Escharotomy
a. A lengthwise incision is made through
the burn eschar to relieve constriction
and pressure and to improve
circulation.
b. Escharotomy is performed for
circulatory compromise caused by
circumferential burns.
c. Escharotomy can be performed at the
bedside without anesthesia, because
nerve endings have been destroyed by
the burn injury.
d. Escharotomy may be necessary on the
thorax to improve ventilation.
e. Following the escharotomy, assess
pulses, color, movement, and sensation
of affected extremity and control any
bleeding with pressure.
f. Pack the incision gently with fine mesh
gauze as prescribed after escharotomy.
g. Apply topical antimicrobial agents to
the area as prescribed.
2. Fasciotomy
a. An incision is made extending through
the subcutaneous tissue and fascia.
b. The procedure is performed if adequate
tissue perfusion does not return
following an escharotomy.
c. Fasciotomy is performed in the
operating room with the client under

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