- Electrolytes (saline): 1 mL × body weight × % TBSA burned
- Glucose (5% in water): 2000 mL for insensible loss
- Day 1: Half to be given in first 8 hours; remaining half over next 16 h.
- Day 2: Half of previous day's colloids and electrolytes; all of insensible fluid
replacement. - Maximum of 10,000 ML over 24 hr. Second- and
Nursing Diagnosis in the Emergent Phase
- Impaired gas exchange related to carbon monoxide poisoning, smoke inhalation, and
upper airway obstruction
- Goal: Maintenance of adequate tissue oxygenation
- Ineffective airway clearance related to edema and effects of smoke inhalation
- Goal: Maintain patent airway and adequate airway clearance
- Fluid volume deficit related to increased capillary permeability and evaporative losses
from the burn wound
- Goal: Restoration of optimal fluid and electrolyte balance and perfusion of vital
organs
- Hypothermia related to loss of skin microcirculation and open wounds
- Goal: Maintenance of adequate body temperature
- Pain related to tissue and nerve injury and emotional impact of injury
- Goal: Control of pain
- Anxiety related to fear and the emotional impact of burn injury
- Goal: Minimization of patient's and family's anxiety
- Collaborative Problems:
- Acute respiratory failure, distributive shock, acute renal failure, compartment
syndrome, paralytic ileus, Curling's ulcer
- Goal: Absence of complications
ACUTE PHASE OF BURN INJURY
- Lasts until wound closure is complete
- Care is directed toward continued assessment and maintenance of the CV and
respiratory systems