Which finding is characteristic during the emergent period after a deep full-thickness burn injury?
A. Blood pressure of 170/100 mm Hg
B. Foul-smelling discharge from wound
C. Pain at site of injury
D. Urine output of 10 mL/hr
Correct Answer: D. Urine output of 10 mL/hr
During the fluid shift of the emergent period, blood flow to the kidney may not be adequate for glomerular filtration. As a result, urine output is greatly decreased. Urine output of 0.5 mL/kg or about 30 – 50 mL/hr in adults and 0.5-1.0 mL/kg/hr in children less than 30kg is a good target for adequate fluid resuscitation.
Option A: Blood pressure is usually low. During this inflammatory response, there is a fluid loss that can cause a sharp and potentially deadly drop in blood pressure known as shock.
Option B: A foul-smelling discharge does not occur during the emergent phase. Third-degree involves the full thickness of skin and subcutaneous structures. It appears white or black/brown. With pressure, no blanching occurs. The burn is leathery and dry.
Option C: Pain does not occur with deep full-thickness burns. There is minimal to no pain because of decreased sensation. Full-thickness burns heal by contracture and take greater than 8 weeks. Full-thickness burns require skin grafting.
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