What is the priority nursing intervention for a burned patient with hyperglycemia?

Maintaining fluid balance is a critical priority for a burned patient with hyperglycemia due to the complexities involved in burn injuries and their systemic effects. After a burn injury, the body undergoes a significant stress response, leading to increased capillary permeability, which can result in substantial fluid loss through the damaged skin and into the interstitial spaces. This condition can lead to hypovolemic shock if not addressed promptly.

In patients with hyperglycemia, often due to stress-induced hyperglycemia or existing diabetes, additional fluid management is essential. Hyperglycemia can cause osmotic diuresis, further contributing to fluid loss. Thus, maintaining adequate fluid balance helps to prevent complications associated with both the burn and hyperglycemic state, ensures proper tissue perfusion, supports kidney function, and aids in the overall recovery process.

Other interventions, such as replacing lost blood or managing electrolyte imbalances, are also important but typically follow the immediate requirement to maintain fluid volume. A neutral pH is less relevant in the acute management of burns, focusing instead on optimizing fluid resuscitation and overall hemodynamic stability.