CNOR Operating Room Nursing

Category - Emergencies

A patient is admitted with severe burns over 50 percent of their body. The nurse inserts an IV to begin fluid administration and for medications. What is the typical process of fluid shift for this type of patient within the first 48 hours?
  1. Fluid is pulled out of the blood vessels and into the tissues.
  2. Fluid is pulled out of the tissues and into the blood vessels.
  3. Fluid maintains equilibrium between the blood vessels and the tissues.
  4. Fluid movement depends on the type of burn and the patient’s electrolyte status.
Explanation
Answer: A-During the first 48 hours following a burn, fluid is pulled out of the blood vessels and into the tissues. The nurse must administer adequate fluids to prevent hypovolemia and subsequent hypotension. The tissues will swell with the excess fluid, but after approximately two to three days, the shift reverses and the fluid returns to circulation.
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