In treating a patient with an electrical burn injury, which medical order should be questioned?

In the context of a patient with an electrical burn injury, administering Lactated Ringer's at 25 mL/hr should raise concerns. Electrical burns can lead to significant damage, including internal injuries and muscle breakdown, often resulting in the release of myoglobin into the bloodstream. This condition, known as rhabdomyolysis, can cause acute kidney injury if not managed properly.

The fluid resuscitation aims to maintain urine output to prevent kidney damage by diluting the myoglobin levels and facilitating its excretion. Typical fluid replacement for a burn patient, especially after electrical injuries, is much higher than 25 mL/hr. The recommended volume often starts at a much higher rate—in the range of 100-150 mL/hr or more, depending on the patient's weight and the extent of burn injury.

This means that a rate as low as 25 mL/hr might not sufficiently support renal perfusion and effectively mitigate the risks associated with myoglobinuria and acute kidney injury. Therefore, questioning that specific order is essential to ensure the patient's safety and effective treatment.