To maintain a positive nitrogen balance in a patient with a major burn injury, what dietary recommendation is appropriate?

For a patient with a major burn injury, maintaining a positive nitrogen balance is crucial for promoting healing and preventing muscle breakdown. A high-protein, low-fat, high-carbohydrate diet is the most appropriate recommendation because protein plays a vital role in tissue repair and regeneration. Burns significantly increase the body's protein needs to repair damaged tissue and support immune function.

While carbohydrates provide energy, which is also necessary in the context of major burns, the emphasis on protein is particularly important to counteract the catabolic state induced by the injury. The incorporation of carbohydrates ensures that the patient receives enough calories to meet increased metabolic demands, while a focus on low-fat options can help minimize the risk of unnecessary weight gain and other complications.

This approach supports not only nitrogen balance but also sustains the energy levels necessary for recovery. The other choices, while they contain elements that can be beneficial in a burn care plan, do not specifically address the critical importance of a high-protein intake combined with appropriate energy sources to fully support recovery and healing in the context of significant tissue injury.