The practical nurse (PN) is making a home visit to an older male adult who was recently diagnosed with Herpes zoster (shingles). The client reports the onset of severe burning pain along the right side of his trunk. What action should the PN take?

The correct answer is choiceD. Contact information for a women’s shelter.

Choice A rationale:

While providing a safety plan is important, it may not be the most immediate or practical resource for a client in an abusive situation. A safety plan is a detailed strategy for leaving an abusive relationship safely, but it requires time and preparation, which may not be feasible in an urgent situation.

Choice B rationale:

Paperwork for a restraining order is a legal step that can help protect the client, but it may not provide immediate safety. The process of obtaining a restraining order can take time, and the client may need immediate shelter and support.

Choice C rationale:

Documenting the report of abuse in the visit summary is important for medical and legal records, but it does not directly provide the client with immediate resources or safety. This documentation can be useful for future legal actions but does not address the client’s immediate need for safety and support.

Choice D rationale:

Providing contact information for a women’s shelter is the most appropriate response because it offers immediate safety and support. Women’s shelters provide a safe haven, counseling, legal support, and other resources necessary for individuals experiencing domestic violence.This option prioritizes the client’s immediate safety and well-being.

The correct answer is Choice D

Choice A: Excruciating pain

• Rationale: While partial thickness burns can be painful, especially in the first few days, excruciating pain is less likely for a stable patient 3 days post-burn. Pain management is a crucial aspect of burn care, but excruciating pain might indicate deeper burns or complications like infection.

Choice B: Elevated blood pressure

• Rationale: Elevated blood pressure is not a typical complication of a partial thickness burn. In fact, burn patients are more at risk for hypotension (low blood pressure) due to fluid loss.

Choice C: Compartment syndrome

• Rationale: Compartment syndrome is a serious complication that typically occurs with deep burns or traumatic injuries. It's caused by increased pressure within a muscle compartment, restricting blood flow and potentially leading to tissue death. While a possibility, it's less likely for a partial thickness burn 3 days after the injury.

Choice D: Curling's Ulcer

• Rationale: Curling's ulcer is a peptic ulcer (stomach ulcer) that can develop as a complication of major burns. This is because burns trigger a massive inflammatory response, releasing stress hormones that increase stomach acid production, making the stomach lining more susceptible to ulcers. Given the extensive burn area (30% TBSA) and the timeframe (3 days post-burn), Curling's ulcer becomes a significant concern.

Therefore, the correct answer is: Choice D: Curling's Ulcer

Explanation:

• A 30% TBSA partial thickness burn is a significant injury that triggers a systemic inflammatory response.
• Three days post-burn falls within the timeframe when Curling's ulcer can develop due to the increased stress hormones and gastric acid production.
• While pain management and monitoring for compartment syndrome are important, Curling's ulcer poses a more significant threat in this scenario.