Burns and Burn Injury Q 21

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Which laboratory result, obtained on a client 24 hours post-burn injury, will the nurse report to the physician immediately?

  

    A. Arterial pH, 7.32

    B. Hematocrit, 52%

    C. Serum potassium,7.5 mmol/L (mEq/L)

    D. Serum sodium, 131 mmol/L (mEq/L)

    

    

Correct Answer: C. Serum potassium,7.5 mmol/L (mEq/L)

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The serum potassium level is changed to the degree that serious life-threatening responses could result. With such a rapid rise in the potassium level, the client is at high risk of experiencing severe cardiac dysrhythmias and death.

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Option A: Acid-base studies were carried out on 76 consecutive burn patients admitted within 36 hours of injury. Admission blood pH and base excess (BE) values all decreased in a linear relationship to the extent of the burn. Blood Pco-2 changes were unrelated to the extent of the burn. Significant acidosis developed within 2 hours of burn injury.

Option B: The hematocrit (Hct) is the percentage of the volume of the whole blood that is made up of red blood cells. In burns, the patient has lost a lot of fluid from leaky blood vessels. There are more red cells than fluid so the hematocrit is high.

Option D: Serum sodium is abnormal, but not to the same degree of severity, and would be expected in the emergent phase after a burn injury. Severe cutaneous injuries such as burn injuries and blast injuries result in the loss of both water and sodium. For burn patients, hypernatremia that occurs within a few days of injury may be associated with an increased risk of death.

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