The burned client relates the following history of previous health problems. Which one should alert the nurse to the need for alteration of the fluid resuscitation plan?
A. Seasonal asthma
B. Hepatitis B 10 years ago
C. Myocardial infarction 1 year ago
D. Kidney stones within the last 6 month
Correct Answer: C. Myocardial infarction 1 year ago.
It is likely the client has a diminished cardiac output as a result of the old MI and would be at greater risk for the development of congestive heart failure and pulmonary edema during fluid resuscitation.
Option A: Asthma is a chronic inflammatory disease of the airways, characterized by recurrent episodes of airflow obstruction resulting from edema, bronchospasm, and increased mucus production. Commonly associated with seasonal allergies (allergic rhinitis) and eczema (atopic dermatitis), these three conditions form what is known as the atopic triad.
Option B: The incubation period of an acute hepatitis B virus infection is approximately 12 weeks, with a majority of patients experiencing mild illness and less than 1% experiencing fulminant hepatic failure. After acute infection resolves, the majority of adult patients and a small percentage of infected infants develop antibodies against the hepatitis B surface antigen and end up recovering fully.
Option D: Nephrolithiasis, or kidney stones, is the most common condition affecting the urinary system, affecting about 12% of the world population, with a yearly incidence of 600,000 in America. It is the result of a crystal or crystalline concretion traveling from the kidney through the genitourinary system.
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