PATHOPHYSIOLOGY

Predisposing Factors: Children ages 4 and under Male child>female child Older adults Black children and adolescent Precipitating Factors: No smoke alarms and fire exit Chemical products especially methamphetamine Careless cooking Improper handling of cigarette lighters, matches, stoves, and candles Electrical sources or lightning Extensive exposure to sunlight and other sources

Heat/chemical contacts with the bodys surface

Heat may be transferred through

Conduction

Electromagnetic reaction

Fluid accumulation phase

Lasts for 36-48 hrs after burn injury

Fluid-remobilization phase

Diuresis stage

Convalescent phase

Tissue destruction

Cause the release of acids

Starts about 48 hours after initial burn

Coagulation

Ionization of cellular contents

Drop in pH level

Fluid shifted back to vascular compartment

Begins after first two phases have been resolved

Subsequent metabolic acidosis Protein denaturation Fluid shift from vascular compartment to interstitial space Hypermetabolic
Causes

Healing or reconstruction Edema at burn site decreases Blood flow to the kidneys of burn wound

Third-space shift

increase

needs

Increase urine output

Edema

Fluid replacement priority rather than nutritional needs during emergent phase Sodium is lost Potassium either moved back into cells or lost through urine

Hyperkalemia

Hyponatremia

Hypernatremia

Hypocalcemia

Circumferential burns Edematous airway Edema of neck or chest Restrict respirations Hypokalemia Hypervolemia Hyponatremia

Shortness of breath Major fluid shifts now resolved Anti-diuretic hormone Damage to capillaries Diminished kidney perfusion Alters the vessel permeability Production and release of stress hormones Aldosterone Decreased urine output Causes kidney to retain sodium and water Inadequate dietary intake

Possible further fluids and electrolytes imbalance exists