Burns and Burn Injury Q 88 - Gyan Darpan : Learning Portal
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Wednesday 30 March 2022

Burns and Burn Injury Q 88

At what point after a burn injury should the nurse be most alert for the complication of hypokalemia?
    A. Immediately following the injury
    B. During the fluid shift
    C. During fluid remobilization
    D. During the late acute phase

Correct Answer: C. During fluid remobilization

Hypokalemia is most likely to occur during the fluid remobilization period as a result of dilution, potassium movement back into the cells, and increased potassium excreted into the urine with the greatly increased urine output. In an attempt to prevent hypokalemia it is advised to add ’20-30 mEq/1 of potassium to the hypotonic fluids in order to compensate for urinary losses and intracellular shift; it is also mandatory to correct precipitating factors such as increased pH, hypomagnesemia, and several drugs.

Option A: In major burns. intravascular volume is lost in burned and unburned tissues: this process is due to an increase in vascular permeability, increased interstitial osmotic pressure in burn tissue. and cellular edema. with the most significant shifts occurring in the first hours. Hyponatremia is frequent, and the restoration of sodium losses in the burn tissue is, therefore, essential hyperkalemia is also characteristic of this period because of the massive tissue necrosis.
Option B: The early post-resuscitation phase is a period of transition from the shock phase to the hypermetabolic phase, and fluid strategies should change radically with a view to restoring losses due to water evaporation. The main changes in this period are hypernatremia, hypocalcemia, hypokalemia, hypomagnesemia, and hypophosphatemia.
Option D: The acute phase of burns is defined as a period extending from the onset of burns with shock to the time taken for wound epithelialization which normally takes about 12 to 14 days if management of burns is adequate.

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