What social behavior is most typical of the school-aged child?

Choice A rationale

Pain is a common symptom in superficial and partial-thickness burns where nerve endings are still intact. While pain indicates tissue damage, the absence of pain in a burn area can signify deeper and more severe injury where nerve endings have been destroyed.

Choice B rationale

No pain with pale, leathery skin is a characteristic finding of a full-thickness (third-degree) burn. The destruction of nerve endings eliminates pain sensation, and the skin appears dry, leathery, and may be white, charred, or translucent due to damage to all skin layers and underlying tissue.

Choice C rationale

Mild erythema, or redness of the skin, is characteristic of a superficial (first-degree) burn, such as a sunburn. These burns involve only the epidermis and are typically painful and without blisters.

Choice D rationale

Blister formation is a hallmark of partial-thickness (second-degree) burns, which involve the epidermis and part of the dermis. These burns are typically painful and moist.

Choice A rationale

Observing for signs of respiratory distress is the priority assessment for a child with burns to the face and neck. Burns in this area can lead to airway edema and compromise, which can rapidly become life-threatening. Assessing for stridor, hoarseness, difficulty breathing, and changes in respiratory rate and effort is crucial for immediate intervention.

Choice B rationale

Monitoring vital signs for indications of shock is important in burn patients due to fluid shifts and potential hypovolemia. However, airway patency takes precedence, as inadequate oxygenation will quickly lead to irreversible damage. Vital signs should be monitored continuously after ensuring the airway is secure.

Choice C rationale

Obtaining a detailed history of the burn incident is necessary for understanding the mechanism of injury and potential associated trauma. However, the immediate priority is to assess and manage any threats to the child's airway, breathing, and circulation. History taking can occur once the child is stable.

Choice D rationale

Evaluating the extent and depth of the burns is crucial for determining the severity of the injury and guiding fluid resuscitation and wound care. However, ensuring a patent airway and adequate breathing is the immediate priority upon the child's arrival in the emergency department.