G.N., a 65-year-old African American man, was admitted to the hospital
emergency department with partial-thickness burns that involved his face, neck, and upper trunk. He also had a lacerated right leg. His injuries occurred about 36 hours earlier when he fell out of a tree onto his gas grill (which was lit) while trimming tree branches.
• Complains of slightly hoarse voice and irritated throat
• States that he tried to treat himself because he does not have health insurance
• Has been coughing up sooty sputum
• Complains of severe pain in left hip
• Leg wound is gaping and has drainage: temperature 101.1° F (38.4° C)
• X-rays reveal a fractured right tibia and fractured left hip
• WBC count 26,400/µL (26.4 × 109/L) with 80% neutrophils (10% bands)
• Surgery is performed to repair the left hip.
1. What clinical manifestations of inflammation did G.N. exhibit, and what are their pathophysiologic mechanisms?
2. What type of exudate formation did he develop?
3. What is the basis for the development of the temperature?
4. What is the significance of his WBC count and differential?
5. Because his wound was gaping, primary tissue healing was not possible. How would you expect healing to take place? What complications could he develop?
6. What risk factors does G.N. have to develop a pressure ulcer?
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