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A client is receiving fluid replacement with Lactated Ringer's after 40% of his body was burned 10 hours ago. The assessment reveals: temperature 36.2° C; heart rate 122; blood pressure 84/42; CVP 2 mm Hg; and urine output 25 ml for the last 2 hours. The IV rate is currently at 375 ml/hr. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the healthcare provider with the recommendation for:

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[TR]

[TD][/TD]

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[TD]Furosemide (Lasix).

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[/TR]

[TR]

[TD][/TD]

[TD][/TD]

[TD]Fresh frozen plasma.

[/TD]

[/TR]

[TR]

[TD][/TD]

[TD][/TD]

[TD]IV rate increase.

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[/TR]

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[TD][/TD]

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[TD]Dextrose 5%.[/TD]

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Specializes in Nurse Leader specializing in Labor & Delivery.

Sorry, we don't do students' homework. If it's not against the TOS, it should be.

Why don't you tell US what YOU think it might be, and your rationale for your choice, and we will let you know if you're on the right track.

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first of all, i dont need your comment..it was a question a friend ask me,

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Specializes in ICU, BURNS, TRAUMA, TRANSPORT, HH.
first of all, i dont need your comment.. it was a question a friend ask me, i

Sorry you found that comment snarky.

It seemed pretty straight forward. The question is clearly an assignment for a nursing student, we recognize them. ;)

No need to take it personally if you are not the student.

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well i think increase the fluid due to low bp and increase HR.. and eliminate lasix and frozen blood

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Specializes in Med/Surg, Ortho, ASC.

Your "friend" asks very detailed questions in the third person. :yes:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
first of all, i dont need your .. boo, it was a question a friend ask me,
We are happy to help with questions however......we request that you tell us what you think first. Our goal is to help others become the best nurses they can be by utilizing their critical thinking skills.

I do not like to answer questions without knowing what you think...I need to have all the information possible so I know how best to help you find the answer on your own and what you are misunderstanding.

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Specializes in Going to Peds!.
Sorry, we don't do students' homework. If it's not against the TOS, it should be.

Why don't you tell US what YOU think it might be, and your rationale for your choice, and we will let you know if you're on the right track.

This.

And we're not buying the friend story.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

The OP has asked a legitimate question...

Our first priority is to the members that have come here because of the flame-free atmosphere we provide. There is a zero-tolerance policy here against personal attacks. We will not tolerate anyone insulting other's opinion nor name calling.

Our call is to be supportive, not divisive

Several posts have been edited or deleted.

moved to nursing student assistance

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Specializes in Nephrology, Cardiology, ER, ICU.

Original poster- can you add to your request please...

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

This patient is a burn patient with a critical (40%) BSA involved. Looking at this scenario what alarms you...

A client is receiving fluid replacement with Lactated Ringer's after 40% of his body was burned 10 hours ago. The assessment reveals: temperature 36.2° C; heart rate 122; blood pressure 84/42; CVP 2 mm Hg; and urine output 25 ml for the last 2 hours. The IV rate is currently at 375 ml/hr. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the healthcare provider with the recommendation for:

[TABLE=class: cms_table]

[TR]

[TD][/TD]

[TD][/TD]

[TD]Furosemide (Lasix).

[/TD]

[/TR]

[TR]

[TD][/TD]

[TD][/TD]

[TD]Fresh frozen plasma.

[/TD]

[/TR]

[TR]

[TD][/TD]

[TD][/TD]

[TD]IV rate increase.

[/TD]

[/TR]

[TR]

[TD][/TD]

[TD][/TD]

[TD]Dextrose 5%.[/TD]

[/TR]

[/TABLE]

What is the most important with burns. What would be the best fluid replacement? According to ALL recommendations for fluid replacement...the current recommendations are......Parkland formula

  • Initial 24 hours: Ringer’s lactated (RL) solution 4 ml/kg/% burn for adults and 3 ml/kg/% burn for children. RL solution is added for maintenance for children:
    • 4 ml/kg/hour for children weighing 0–10 kg
    • 40 ml/hour +2 ml/hour for children weighing 10–20 kg
    • 60 ml/hour + 1 ml/kg/hour for children weighing 20 kg or higher

    This formula recommends no colloid in the initial 24 hours.

    [*]Next 24 hours: Colloids given as 20–60% of calculated plasma volume. No crystalloids. Glucose in water is added in amounts required to maintain a urinary output of 0.5–1 ml/hour in adults and 1 ml/hour in children.

The MODIFIED PARKLAND

  • First 24 hours: Crystalloids 1 ml/kg/% burn plus colloids at 1 ml/kg/% burn plus 2000 ml glucose in water

  • Next 24 hours: Crystalloids at 0.5 ml/kg/% burn, colloids at 0.5 ml/kg/% burn and the same amount of glucose in water as in the first 24 hours

what are crytalloids? what are colloids? Youare 10 hours into the burn what should you ask the MD for?

IVchart.pdf

Chart of Commonly Transfused Blood Products-1.doc

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The OP, not having gotten an answer to her homework, has resorted to bluster. We can name this tune in three notes ... and, OP, if you are still reading, so can your faculty.

Good luck!

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