According to Grossman and Porth (2014), burns cause fluid loss from the vascular space, interstitial space, and intracellular space. The fluid loss, especially in those with large surface area burns, can cause hypovolemic shock quickly, which can cause hypoperfusion of organs and ultimately multiple organ dysfunction, such as renal failure. Fluids can help reduce the risk of kidney damage. The provider should supportively explain these concepts of fluid loss, hypovolemic shock, and the prevention of kidney injury using simpler terms without jargon. Informing him of these concepts by explaining fluid loss similar can be done by using the example of a skin injury like a laceration or a burn. One should describe the oozing of serum and blood from
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This guides providers to tailor the fluid resuscitation rate by either increasing or decreasing the infusion in response to decreased or increased urine output respectively. Urine output should be 1-2ml/kg/hr. To monitor this output, a catheter is warranted for critical care providers to quickly address changes in fluid status and prevent complications related to a deficit or an overload in fluid volume. If it is less, then either the rate should be increased or colloidal fluids should be started. Biasini et al. (2014) recommends infusing 5% albumin for pediatric burns 40% or greater 48 hours after the injury with a rate of 0.3-0.4 ml/hour multiplied by TBSA percentage of the burn. To prevent confusion in a very stressful situation, the provider should answer the father concisely by informing him that hourly urine output reflects his son’s fluid volume status, and an indwelling urinary catheter with a urometer is needed for this …show more content…
The innate aspect of the immune system has been negatively affected from this injury, and as Grossman and Porth (2014) described, the “the destruction of the skin also prevents the delivery of cellular components of the immune system to the site of injury” (p. 1570). Broad spectrum antibiotics may be used to reduce this risk, due to the high mortality of burn-related sepsis. Reverse isolation, which is to protect the patient from exposure to opportunistic and pathologic microbes should be implemented. Antimicrobial topical agents, such as silver sulfadiazine, secured with dressings can help the damaged protective barrier. If the burns do not heal from supportive measures via wound care, then surgical excision and skin grafts will be necessary to reduce the risk of sepsis. Eschar can develop from these burns, which is a breeding ground for bacteria. Surgery removes this layer of necrotic flesh and places healthy skin on top of the burn to increase healing, wound closure, and reduce infection from exposure (Grossman & Porth,
This guides providers to tailor the fluid resuscitation rate by either increasing or decreasing the infusion in response to decreased or increased urine output respectively. Urine output should be 1-2ml/kg/hr. To monitor this output, a catheter is warranted for critical care providers to quickly address changes in fluid status and prevent complications related to a deficit or an overload in fluid volume. If it is less, then either the rate should be increased or colloidal fluids should be started. Biasini et al. (2014) recommends infusing 5% albumin for pediatric burns 40% or greater 48 hours after the injury with a rate of 0.3-0.4 ml/hour multiplied by TBSA percentage of the burn. To prevent confusion in a very stressful situation, the provider should answer the father concisely by informing him that hourly urine output reflects his son’s fluid volume status, and an indwelling urinary catheter with a urometer is needed for this …show more content…
The innate aspect of the immune system has been negatively affected from this injury, and as Grossman and Porth (2014) described, the “the destruction of the skin also prevents the delivery of cellular components of the immune system to the site of injury” (p. 1570). Broad spectrum antibiotics may be used to reduce this risk, due to the high mortality of burn-related sepsis. Reverse isolation, which is to protect the patient from exposure to opportunistic and pathologic microbes should be implemented. Antimicrobial topical agents, such as silver sulfadiazine, secured with dressings can help the damaged protective barrier. If the burns do not heal from supportive measures via wound care, then surgical excision and skin grafts will be necessary to reduce the risk of sepsis. Eschar can develop from these burns, which is a breeding ground for bacteria. Surgery removes this layer of necrotic flesh and places healthy skin on top of the burn to increase healing, wound closure, and reduce infection from exposure (Grossman & Porth,