A client receiving treatment for severe burns over more than half of his body has an indwelling urinary catheter inserted. When evaluating the client's intake and output, which of the following should be taken into consideration? The amount of urine:
is expected to be decreased for three to five days.
will be reduced in the first 24-48 hours and will then increase.
output will be greatest in the first 24 hours after the burn injury.
will be elevated due to the amount of intravenous fluids administered during the initial phases of treatment.
The Correct Answer is B
A. is expected to be decreased for three to five days.
In the initial stages following severe burn injury, there is often oliguria (low urine output), but this is typically followed by diuresis (increased urine output) after the first 24-48 hours, not a decrease over 3-5 days.
B. will be reduced in the first 24-48 hours and will then increase.
In the first 24-48 hours following a severe burn injury, the body may undergo a state of hypovolemia and oliguria. As fluid resuscitation begins, urine output typically increases.
C. output will be greatest in the first 24 hours after the burn injury.
Although urine output may increase with proper fluid resuscitation, it is not usually greatest in the first 24 hours; the increase typically happens after the initial resuscitation period.
D. will be elevated due to the amount of intravenous fluids administered during the initial phases of treatment.
While fluid resuscitation leads to an increase in urine output after the first 24-48 hours, it is not expected to be elevated right away. The kidneys may initially respond with oliguria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Administer each unit of blood over 3–4 hours
Older clients with CHF cannot tolerate rapid fluid shifts. Blood should be administered slowly (over 3–4 hours per unit) to prevent fluid overload.
B. Anticipate an order for acetaminophen
Acetaminophen is not routinely given before blood transfusions unless the client has a history of febrile reactions.
C. Anticipate an order for furosemide administration
Loop diuretics like furosemide may be ordered between units to prevent fluid overload in CHF patients.
D. Assess for signs and symptoms of fluid overload
CHF patients are at high risk for fluid overload, leading to dyspnea, crackles, and increased BP.
E. Anticipate administration of fresh frozen plasma (FFP) for the next transfusion
FFP is given for coagulation disorders, not for treating anemia in a GI bleed.
Correct Answer is B
Explanation
Parkland Formula:
Total fluid requirement (ml)=4×Body weight (kg)×Total body surface area burned (%TBSA)
= 4×70×70
=19,600mL (total for 24 hours)
Fluids in first 8 hours: 19,600mL÷2
=9,800mL
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