A 65 year old male patient has experienced full-thickness electrical burns on the legs and arms. As the nurse you know this patient is at risk for the following: Select all that apply:

A. Acute kidney injury (AKI)is a common complication of electrical burns due to myoglobin release from muscle damage (rhabdomyolysis). Myoglobin can accumulate in the kidneys, causing renal tubular obstruction and acute tubular necrosis.

B. Dysrhythmiascan occur because electrical currents pass through the body and disrupt cardiac conduction, leading to arrhythmias, which may be life-threatening. Continuous cardiac monitoring is essential.

C. The iceberg effectrefers to the fact that electrical burns often cause deeper tissue injury than is visible on the skin, including muscle, nerve, and bone damage beneath the surface. This hidden injury can lead to complications such as compartment syndrome and rhabdomyolysis.

D. Hypernatremiais not a primary risk in electrical burns. Electrolyte imbalances are more commonly hyponatremia or hyperkalemia, especially during fluid shifts and muscle breakdown.

E. Bone fracturesmay occur if the patient experienced violent muscle contractions during the electrical shock. Electrical currents can cause severe tetanic muscle contractions, which can lead to fractures, especially in older adults with decreased bone density.

F. Fluid volume overloadis not typically a risk immediately after electrical burns. The initial concern is hypovolemia from fluid loss due to capillary leak and tissue injury, requiring aggressive fluid resuscitation. Overload may occur later if fluids are over-administered, but it is not an inherent risk of the burn itself.

A. Dislocated right hip and an open fracture of the right lower legis incorrect for red-tag triage because, while painful and requiring urgent care, these injuries are not immediately life-threatening. This client would typically be triaged as yellow (urgent but can wait a short time for treatment).

B. Large contusion to the forehead and a bloody noseis incorrect because these are minor injuriesthat are not life-threatening. This client would be triaged with a green tag (delayed, “walking wounded”).

C. Closed fracture of the right clavicle and arm numbnessis incorrect because, although this is a concerning injury with possible nerve involvement, it is not immediately life-threatening. This client may also receive a yellow tag.

D. Multiple fractured ribs and shortness of breathis correct because rib fractures combined with respiratory distressindicate a potentially life-threatening condition, such as flail chest or pneumothorax. These conditions can compromise oxygenation and circulation, requiring immediate intervention. In triage, red tags are assigned to clients who need life-saving care without delay.