Chapter 36 Case Study-Burn InjuryShanelle Hawkins, 6-years-old, was admitted to the hospital with a deep partial thickness burn after dropping a bowl of hot soup on her leg. By her second day of hospitalization, it was determined that Shanelles burn is partial thickness and that no skin grafting is need. Parents often have a difficult time doing dressing changes due to the amount of pain it causes to the child, so Shanelle was discharged with twice weekly dressing changes scheduled in the hospitals burn clinic. Shanelle has come to the clinic for her first debridement and dressing change since being discharged 3 days ago. Shanelles mother gave her pain medication prescribed prior to leaving home for the clinic visit, but Shanelle is still anxious about how much the dressing change is going to hurt. Her mother is encouraged to stay with her during the dressing change to provide support and diversion. When the dressing and exudate are removed, granulation tissue is seen and no odor is detected that would indicate an infection. Topical medication and the burn dressing are applied. After the dressing change, some time is spent talking with Shanelles mother. She reports that Shanelle has been eating the recommended high-protein, high-calorie diet and drinking generous amounts of fluids to promote wound healing. She is concerned about how much trouble Shanelle has extending her leg and walking. She knows the movement hurts when it stretches the burned skin, but she wonders if Shanelle is moving her leg enough. 1. What are potential appropriate pain medications to give Shanelle for a dressing change? How far in advance of the wound debridement should the pain mediation be administered? 2. Describe complementary interventions that could further reduce Shanelles pain and anxiety. 3. Identify three interventions that could potentially reduce the psychological impact of the burn injury on Shanelle. 4. What suggestions can you make to encourage Shanelle to mobilize independently despite the pain that leg movement causes? 5. Discuss food choices with Shanelles mother, and help her plan a high-calorie diet with additional protein that includes food Shanelle enjoys to promote healing.