Burns II - Major Burns

Pathophysiology Course

Pathophysiology
Low fluid volume
Massive tissue damage & cellular destruction leads to
widespread systemic inflammation that increases vascular
!
permeability (leaky blood vessels that fill up the body like a !
water balloon). This results in low fluid volume within the
blood vessels leading to Hypovolemic Shock & then death! !

Signs & Symptoms

First 24-hours Over 5.0

K
High Potassium (Hyperkalemia)
Over 5.0
� Potassium Priority Pumps heart
� HIGH Potassium = HIGH Pumps
� Tall, Peaked T Waves on ECG
NCLEX TIP
Fluids FLOW - electrolytes GO!!!
HEMOGLOBIN HEMATOCRIT
Low Sodium (hyponatremia) 12-18 normal 36-54% normal
Below 135 NCLEX TIP
!
Elevated H/H
� Hemoglobin: 12 - 18 normal
! Na
� Hematocrit: 36 - 54% normal !

Treatments
PRIORITY
IV Lactated Ringer’s IV Normal Saline
KEY Term (LR) solution (0.9% sodium Chloride)

LACTATED RINGER’S

#1 Intervention first 24-hours

LACTATED RINGER’S 0.9%
Sodium Chloride
250 mL

NaCl 0.9%
IV Lactated Ringer’s (LR) solution
IV Normal Saline

Assessment of Administer enteral feedings

Fluid Resuscitation ≥ 90 Systolic
Once bowel sounds return
≥ 30 mL/hr
90

1. Urine output
30 mL/hr or MORE NCLEX TIP
#1
2. Blood pressure
≥ 30 mL/hr
(90/systolic Or MORE)
< 120/min
3. Heart rate less than 120/min.

Notes