Question

(5 Points)

Scenario

In the emergency department (ED) of a community hospital when the ambulance arrives with A.M., a 28-year-old woman who was involved in a house fire. She was sleeping when the fire started and managed to make her way out of the house through thick smoke. The emergency medical system crew initiated humidified oxygen at 15L/min per non-rebreather mask and started a 16-gauge IV with lactated Ringer's solution. On arrival in the ED, her vital signs are 100/66, 125, 34, Spo2 93%. She appears anxious and in pain.

Vital Signs

Blood pressure               90/50 mm Hg Heart rate                       130 beats/min Respiratory rate              24 breaths/min Temperature                   99.0° F (37.2° C)

Eighteen hours after the injury, the UAP reports these vital signs for A.M. and states that the urine output for the past hour was 20mL.

1. What do you suspect is occurring, and why does this concern you?

2. What treatment do you anticipate?

3. By the end of your shift, which of the following assessment findings would best indicate that A.M. is responding to therapy?

1. Respiratory rate 22; blood pressure 120/74
2. Heart rate 110; average urine output 20mL/hr for past 4 hours
3. Blood pressure 120/70; average urine output 25mL/hr for past 4 hours
4. Blood pressure 104/64; average urine output 40mL/hr for past 4 hours

Answer 1

Answer: The suspect is suffering from dehydration. In the case of burn, dehydration occurs. This have major concern as it is important to keep the patient hydrated otherwise abnormalities will occurs.

IV infusions to provide fluid to the patient is important to maintain the hydration. The IV infusion will prevent from shock and reduce further injuries.

The blood pressure 120/70, average urine output 25ml/hr for past 4 hours. This shows that the patient is showing better response.