A patient is complaining of increased pain to the area of a third-degree burn covering the entire arm. The nurse suspects compartment syndrome. For which intervention would the nurse prepare the patient?
1. Transportation to the whirlpool
2. Application of multiple ace wraps over the current gauze dressing
3. An escharotomy performed by the physician
4. Skin grafting performed by the physician
3
Rationale 1: The whirlpool would provide no remedy for the impaired circulation.
Rationale 2: Ace wraps would provide no remedy for the impaired circulation.
Rationale 3: Circumferential burn wounds to the neck, chest, abdomen, and extremities are at risk for developing compartment syndrome. The burn eschar constricts the burned area at the same time that edema is causing subcutaneous fluid expansion. The net result is impaired circulation to the involved area. Compartment syndrome is prevented by performing an escharotomy whereby the physician uses a scalpel or electrocautery to cut through the eschar, which releases tension and permits blood flow to the area. Escharotomies are usually performed at the bedside. The nurse should be prepared to assist in draping and monitoring the patient during the procedure.
Rationale 4: Skin grafting would provide no remedy for the impaired circulation.
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