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During waking hours for 2 to 3 months after the injury: Wearing the garment only while awake provides insufficient pressure to control hypertrophic scarring. These garments require near-continuous wear for many months to achieve adequate collagen remodeling.

4 to 6 hours a day for 6 months: This amount of daily use is far too limited to influence scar tissue formation. Pressure therapy must be applied almost continuously to keep collagen fibers flattened and prevent thick, raised scars.

Only at night while sleeping for a year after the injury: Night-only wear does not maintain the necessary constant pressure needed for optimal scar management. Scar tissue forms throughout the day, and removal for long hours reduces therapeutic effect.

Cardiac monitor shows a pulse rate of 204: A markedly elevated heart rate is expected during the early burn-shock phase due to pain, stress, and circulating catecholamines. Although it indicates a hypermetabolic and hypovolemic state, it is not as specific for inadequate fluid resuscitation as reduced urine output, so it is not the most urgent finding.

Serous exudate is leaking from the burns: Plasma leakage from damaged capillaries is normal in the first 24–48 hours after a major burn. While this contributes to hypovolemia, its presence alone does not indicate a worsening condition and does not require immediate provider notification compared with signs of renal hypoperfusion.

Blood pressure is 94/50 per arterial line: Borderline hypotension commonly occurs during early burn shock because of fluid shifts into the interstitial space. Although concerning, it is less reliable than urine output for assessing end-organ perfusion.

Increased capillary ref: Prolonged capillary refill can suggest reduced circulation, but it appears earlier and is less definitive than the complete loss of palpable pulses. While concerning, it does not carry the same urgency or confirm the need for surgical decompression.

Increased sensitivity to pain in the area: Heightened pain sensitivity may occur as tissues swell, but pain alone does not indicate critical circulatory obstruction. The presence or absence of pain is not a reliable determinant for the need for escharotomy compared with pulse changes.

Limited range of motion: Decreased mobility is common with circumferential burns due to stiffness and swelling, but it does not reliably signal vascular compromise. Although it affects function, it is not an indication for emergent escharotomy in the absence of circulatory impairment.

pulmonary edema: Pulmonary edema presents with crackles, dyspnea, and frothy sputum, but it does not typically cause a hoarse voice or a brassy cough. These findings point more specifically to airway irritation rather than fluid accumulation in the lungs.

pneumonia: Pneumonia usually causes fever, productive cough, and abnormal breath sounds. It does not typically produce hoarseness or a brassy cough immediately after a burn injury, making it a less likely explanation for these acute airway symptoms.

carbon-monoxide poisoning: Carbon monoxide poisoning presents with headache, confusion, and cherry-red skin coloration, but it does not cause hoarseness or irritation of the airway. A brassy cough is not characteristic of this condition.

depth of the burn, weight of the client: Burn depth is indeed an important factor in determining severity, but client weight does not play a direct role in classifying burn severity. Weight may influence fluid needs but does not determine how severe the burn injury itself is.

gender of the client, duration of the burn: Neither gender nor the duration of contact alone determines burn severity. Duration may influence burn depth, but it is not an independent classification factor, and gender is not related to burn injury severity.

amount of surface area of the body that is burned, gender of the client: The total body surface area burned is important, but gender is not used in determining severity. Burn assessment tools evaluate surface area, but gender has no clinically relevant effect on the classification.

36%: This would overestimate the burned area. The Rule of Nines assigns 18% to the entire anterior trunk and 9% to each entire arm. Only the anterior surfaces are involved here, so this value is too high.

18%: This only accounts for the anterior trunk. The anterior aspects of both arms add additional surface area, so 18% underestimates the total burned area.

30%: This does not accurately sum the anterior surfaces. Each arm’s anterior surface is approximately 4.5%, and the anterior trunk is 18%, totaling less than 30%.

hypokalemia, hypernatremia, and hypoalbuminemia: Hypokalemia and hypernatremia are not expected early findings after a major burn. Potassium initially rises due to massive cell destruction, and sodium commonly falls because of fluid shifts into the interstitial space, making this pattern inconsistent with the emergent phase.

hyperkalemia, hypernatremia, and hyperalbuminemia: Although hyperkalemia is expected, hypernatremia is unlikely because sodium shifts into the tissues with extensive edema. Albumin levels usually fall due to increased capillary permeability and plasma protein loss, so hyperalbuminemia would not be seen.

hyperkalemia, hyponatremia, and metabolic alkalosis: The potassium and sodium patterns fit early burn physiology, but metabolic alkalosis does not. Massive fluid loss, hypoperfusion, and lactic acid accumulation commonly produce metabolic acidosis rather than alkalosis during the emergent period.

bone marrow transplant: Bone marrow transplant does not reverse hyperacute rejection. This type of rejection occurs because of pre-existing antibodies, and once the process begins, the damage progresses too rapidly for immune-modulating procedures like marrow transplant to be effective.

immediate dialysis to prevent damage to the new kidney: Dialysis may be needed after the kidney is removed, but it does not stop the rejection process. Hyperacute rejection results in irreversible vascular injury to the graft, so dialysis cannot salvage the transplanted organ.

high-dose intravenous cyclosporin therapy: Cyclosporin is useful for preventing or managing acute rejection, not hyperacute rejection. In hyperacute rejection, the tissue damage occurs within minutes to hours, and immunosuppressive therapy cannot reverse the destruction once it has begun.

alkaline phosphatase level, creatinine level, and blood urea nitrogen level: Alkaline phosphatase is a liver and biliary enzyme and does not help assess acute kidney injury. Although creatinine and BUN are relevant, the inclusion of alkaline phosphatase makes this combination less useful for evaluating renal damage.

urine specific gravity, albumin level, and alkaline phosphatase level: Urine specific gravity is helpful, but albumin and alkaline phosphatase reflect nutritional or hepatic status rather than renal perfusion. These do not provide the needed information to determine acute kidney injury onset.

serum albumin level, alkaline phosphatase level, and blood urea nitrogen level: Albumin and alkaline phosphatase are not indicators of kidney function. BUN alone cannot determine acute kidney injury without creatinine or urine concentration data.