Question

jenny, a 19 year-old college student, was injured in a fire resulting from a car accident. She experienced full-thickness burns over approximately 10% of her body. Consider the clinical model that is most related to this process. From your reading related to fluid ,electrolyte, and acid-base balance, answer the following questions: 1- what anatomic problem would most likely lead to fluid shifts because of burn injury? 2- what is the cause of fluid shifts in burn injury ? 3- How would you manage fluid shifts in burn injury? 4- what would you expect for clinical manifestation? 5- what diagnostic tests might be used?

Answer 1

1.The most severe problem that the patient faces is loss of fluids from burned area ,due to altered skin integrity.Fluid is lost from circulation almost immediately after the burn injury.The more severe the burn,more quantity of fluid is lost.

2.In a severe/full thickness burn ,the nerve endings get destroyed, due to which the body barriesr against water loss is destroyed.Therefore, the fluid seeps from the burned area causing dehydration and electrolyte imbalance.

3.Fluid replacement is one of the immediate treatment as it prevents shock and maintains adequate perfusion of blood.The crystalloid ringers lactate which is an isotonic solution is most preferred as it matches the composition of extracellular fluid.It is given intavenously.

4.Patient develops hypovolemia(decreased blood volume) which can lead to multi organ failure.Decreased blood pressure(hypotension) and increased heart beat(tachycardia) are signs of shock.Decrease in urine output is a sign of inadequate vascular volume.Electrolyte imbalance may lead to alteration in cellular functions.Acid-base imbalance also occurs because of ion shifts.

5.To determine cardiovascular status, heart rate and blood pressure should be monitored.Urine output should be monitored to assure adequate fluid resuscitation.Electrolytes specially, sodium and potassium ashould be monitored.Arterial blood gas to determine acid- base status must be done.