Case Study Assignment. You are a medical student working your way through
college and are assigned to a hospital given background information on a patient.
You were provided the chief complaint and brief history of the patient outlined
below. You are asked by the nurse in charge to read the following case,
investigate the topic (severe burns and function of the integumentary system)
and complete a written report in MLA format including references addressing
each of the questions identified below. Use this link for guidance on MLA writing
format:
https://owl.purdue.edu/owl/research_and_citation/mla_style/mla_formatting_and_
style_guide/mla_general_format.html
Total length of your report should be about two to three pages. The purpose of
this assignment is to put things you are learning in the course (lecture and lab)
into context using real life situations. This assignment’s focus is to investigate
real issues of the integumentary system and epithelial tissues.
Chief Complaint: A 60-year-old female was admitted for severe second- and third-degree
burns following her rescue from a burning house.
History: Susan Pritchard, a 60-year-old female, was received in the emergency room and was
reported to have been rescued from her burning house by the neighbor. The neighbor’s family
dog was able to wake up the neighbor and they saw flames coming from the windows and
heard a person screaming. Investigations at the scene suggest the patient was asleep at night
when a spark from the family fireplace started a fire, leaving her trapped in her bedroom. By the
time the fire rescue squad arrived, the patient had been rescued but emergency crews reported
she had suffered severe burns and excessive smoke inhalation.
In the emergency room, Susan was unconscious. She had second-degree burns over 9% of her
body and third-degree burns over 18% of her body — both covering her thoracic and abdominal
regions and her right elbow. Her vital signs were quite unstable: blood pressure = 60 / 37; heart
rate = 212 beats / min.; and respiratory rate = 40 breaths / min. She was quickly deteriorating
from circulatory failure. Two IVs were inserted, and fluids were administered through each. Her
vital signs stabilized, and she was transported to the intensive care unit (ICU).
Susan regained consciousness the following morning, surprisingly complaining of only minor
pain over her trunk. Following debridement of her burns and application of a broad-spectrum,
topical antibiotic, a plastic epidermal graft was applied over the burned areas. Despite treatment
with a broad-spectrum antibiotic, she developed a systemic staphylococcal infection,
necessitating a switch to a different antibiotic.
Susan began a long, slow recovery. Her position in bed had to be changed every 2 hours to
prevent the formation of decubitus ulcers. She lost 17 pounds over the next 3 weeks, despite
nasogastric tube feeding of 5000 calories (“Kcals”) per day. After 9 weeks, sheets of cultured
epidermal cells were grafted to her regenerating dermal layer. By the 15th week of her
hospitalization, her epidermal graft was complete, and she was back on solid foods, her
antibiotics were discontinued, and she was discharged from the hospital with a rehabilitation
plan for both physical and occupational therapy at home, as well as twice-weekly visits by a
nurse.
Questions for you to address in your report. Your supervisor asks you to prepare a 2 to 3
page report to accomplish two things: 1) evaluate your knowledge about the integumentary
system and how the body deals with severe stress as well as the specifics about the case; and
2)
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