The nurse is reviewing laboratory values for a patient receiving treatment during the emergent phase of burn management. Which laboratory result should the nurse expect for the patient at this time:
A.
Increased hematocrit
B.
Decreased blood urea nitrogen (BUN)
C.
Decreased serum potassium
D.
increased serum albumin
The correct answer and Explanation is :
The correct answer is A. Increased hematocrit.
Explanation:
In the emergent phase of burn management, also known as the resuscitative phase, several physiological changes occur in response to the burn injury, primarily involving fluid shifts. This phase typically lasts from the time of the burn injury until about 48-72 hours after the injury.
Burns cause significant damage to the skin and underlying tissues, leading to increased capillary permeability. This increased permeability results in fluid leakage from the intravascular space into the interstitial and intracellular spaces (third-spacing). As a result, the patient experiences hypovolemia, or a reduction in blood volume, since fluids are lost from the circulatory system.
In response to this fluid loss, the concentration of red blood cells in the remaining blood increases, leading to an increased hematocrit. Hematocrit refers to the proportion of red blood cells in the blood. With the loss of plasma volume and no immediate loss of red blood cells, the ratio of cells to fluid rises, making the blood more concentrated. This condition, called hemoconcentration, is a hallmark of the emergent phase of burn injury. Without appropriate fluid resuscitation, this can lead to reduced perfusion and shock.
- BUN (Blood Urea Nitrogen) levels are usually increased during this phase due to dehydration and the breakdown of proteins from damaged tissues.
- Serum potassium is typically increased during the emergent phase due to the release of potassium from injured cells into the bloodstream.
- Serum albumin is often decreased as it is lost from the vasculature into the tissues along with other proteins during the fluid shifts.
Therefore, increased hematocrit is an expected finding in a burn patient during the emergent phase.