- Pneumonia is a concern which can result in respiratory failure requiring mechanical
ventilation - Infection (Topical antibiotics – Silvadene)
- Tetanus toxoid
- Weight daily without dressings or splints and compare to pre-burn weight
- A 2% loss of body weight indicates a mild deficit
- A 10% or greater weight loss requires modification of calorie intake
- Monitor for signs of infection
Fluid and electrolytes changes in the acute phaseObservation Explanation
Hemodilution (decreased
hematocrit)
Blood cell concentration is diluted as fluid enters the intravascular compartment; loss of
red blood cells destroyed at burn siteIncreased urinary output Fluid shift into intravascular compartment increases renal blood flow and causes
increased urine formation.Sodium (Na+) deficit With diuresis, sodium is lost with water; existing serum sodium is diluted by water
influx.Potassium (K+) deficit (occurs
occasionally in this phase)
Beginning on the fourth or fifth postburn day, K+ shifts from extracellular fluid into
cells.Metabolic acidosis Loss of sodium depletes fixed base; relative carbon dioxide content increases.
Local and Systemic Signs of Infection- Gram Negative Bacteria- Pseudomonas, Proteus
- May led to septic shock
- Conversion of a partial-thickness injury to a full-thickness injury
- Ulceration of health skin at the burn site
- Erythematous, nodular lesions in uninvolved skin
- Excessive burn wound drainage