Case Study: “Grandma, I’m here!” Tiffany announced as she walked into her grandmother’s farm kitchen. It was time for their fall ritual of canning tomatoes and making dill pickles. Tiffany had j
Case Study:
“Grandma, I’m here!” Tiffany announced as she walked into her grandmother’s farm kitchen. It was time for their fall ritual of canning tomatoes and making dill pickles. Tiffany had just started her nursing degree and was glad to get away from studying and classes to spend time with 75-year-old Hazel. Hazel’s tomato plants had produced a bountiful yield, so it took all morning to harvest the fruit.
While Tiffany prepared the tomatoes, Hazel sterilized the jars by immersing them into the hot water bath in the canner. As she used the special tongs to lift out the jars, one slipped and splashed the steaming water directly onto her forearm and hand. “Blast it!” Hazel exclaimed and hurried to the sink to cool her arm under running water. Tiffany raced over and saw that Hazel’s skin was reddened over her hand and forearm. Blisters filled with clear fluid were beginning to form in a small area on her forearm. Tiffany pressed lightly on a reddened area and noticed that it blanched. When she removed her finger from her grandmother’s skin, it promptly turned an angry red again.
“Grandma, those blisters mean that your burn is pretty deep. We better get you to the urgent care clinic,” Tiffany said.
“Just let me get some painkillers,” Hazel replied. “It hurts already, so I think you better drive.”
At the clinic, Dr. Stanford took a history of the event and examined the damaged tissue. “You were smart to come in now,” Dr. Stanford told Hazel and Tiffany as he applied an antimicrobial cream to the burned areas. “The most serious is this blistered area on your forearm. It involves the top layer of skin, called the epidermis, and portions of the next layer, the dermis. The fact that the area hurts is actually a good sign, because it means that the nerve supply to the skin wasn’t destroyed. The other burns aren’t as serious, but there is still damage to the epidermis. Infections are the main complication in this situation. You will have to be meticulous in keeping the area clean, so the burns can heal without delay. I also want you to apply this antimicrobial cream daily and keep the area covered with a special nonstick sterile dressing. We can give you a supply to take home for your dressing changes. The red areas should heal in about six days, but the blistered area may take up to three weeks to heal. You will be in pain for a while, so I’ll give you a prescription for painkillers.”
The body’s first line of defense, intact skin, was compromised when Hazel suffered these burns.
Question: Hazel’s deep wound was painful, moist, warm, and prone to infection. Describe with some detail, the two layers of the skin affected by the burn AND why her skin is now prone to infection.
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