Burns and Burn Injury Q 65

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A 40-year-old male client who was burned was admitted under your care. Assessment reveals he has crackles, respiratory rate of 40/min, and is coughing up blood-tinged sputum. What action will the nurse take first?

  

    A. Administer digoxin

    B. Perform chest physiotherapy

    C. Monitor urine output

    D. Place the client in an upright position

    

    

Correct Answer: D. Place the client in an upright position

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Pulmonary edema can result from fluid resuscitation given for burn treatment. This can occur even in a young healthy person. Placing the client in an upright position can relieve lung congestion immediately before other measures can be carried out.

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Option A: Digoxin may be given later to increase cardiac contractility to prevent backup of fluid into the lungs. However, digoxin has the potential to cause bradyarrhythmias.

Option B: Chest physiotherapy will not get rid of the fluid and is not a priority among the choices. Chest physiotherapy is only applicable during the post-burn management of the patient.

Option C: Monitoring urine output is important. However, it is not an immediate intervention. Use the patient’s urine output and physiologic response to determine if the volume is adequate for resuscitation.

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