A.N.'s burns are being treated by the open method with topical application of silver
sulfadiazine (Silvadene). In caring for A.N., which interventions will you perform? Select all
that apply.
a. Shave all hair within the wound beds
b. Maintain the room temperature at 85 ° F (29.4 ° C)
c. Use clean technique when changing A.N.'s dressings
d. Monitor the CBC and WBC with differential frequently
e. Do not allow her to bathe for the initial 72 hours after injury
f. Apply a 1?16-inch film of medication, covering entire burn
a, b, d, f
Chilling is a concern with the use of the open method. The patient loses more heat through the
burned areas because of injury to the vascular bed, which normally regulates heat loss. A room
temperature of 85 ° F would be appropriate. Heat lamps and heat shields can also be used. No
dressing changes are used with the open method. Aseptic technique is essential during procedures
to decrease the risk of infection. The systemic effects of silver sulfadiazine include leukopenia and
interstitial nephritis. If leukopenia develops, the medication is discontinued. A.N. would be allowed
to bathe. Apply a 1?16-inch film of medication, keeping the burn covered at all times. A.N. would be
allowed to bathe once daily, usually in a shower or tub. Shaving all hair within wound beds will assist
in preventing wound contamination.
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