Eliza Gentry, 8 tuổi, trải qua một chấn thương ghi vào cổ, mặt và ngực (25% của cơ thể với một phần và đầy đủ độ dày vết thương) sau khi một pháo cô đang chơi trong phòng của cô phát nổ trong khuôn mặt của cô. Phòng đầy khói từ một đám cháy khi Eliza đã được cứu sống. | 180 Fluids and Electrolytes Demystified Case Application Eliza Gentry age 8 experienced a burn injury to the neck face and chest 25 percent of the body with partial- and full-thickness wounds after a firecracker she was playing with in her room exploded in her face. The room was full of smoke from a resulting fire when Eliza was rescued. While determining how to approach Eliza s care the nurse considers the following Airway Since oxygen delivery is primary to life the nurse checks that Eliza s airway is patent and assists the primary-care provider in inserting an endotracheal tube for assistive ventilation. Additional respiratory support likely will include Oxygen supplementation Suctioning to remove excess secretions and smoke particles Hyperbaric chamber if carbon monoxide poisoning is suspected Arterial blood-gas determination and oxygen saturation levels to evaluate status Circulation and urinary systems Fluid loss is anticipated because significant body surface was affected. Fluid shifts will result in hypovolemia and hemoconcentration. Treatment will include Intravenous fluids at a rate calculated for body surface area. Albumen infusion as indicated. Blood pressure check hourly. Urine output color and amount . Intake and output. The nurse will closely monitor for signs of renal compromise and related electrolyte and acid-base imbalances. Eliza s level of consciousness and orientation will be monitored with the understanding that the causes of alterations could be multiple . hypovolemia acidosis Na Ca2 and K disturbances . In addition the nurse will monitor the patient s neuromuscular responses . Ca2 K and HPO4- . Laboratory values as ordered will be monitored for imbalance. As indicated earlier patient symptoms may be due to multiple imbalances that occur with injury. It is not essential in all circumstances to determine the precise cause of each symptom. Hypovolemia will be treated and will address circulatory and renal concerns. Treatment of renal .
