What should a nurse assess when caring for a burn patient in terms of fluid resuscitation?

When managing fluid resuscitation in a burn patient, it is crucial to monitor both hematocrit and urine output as indicators of the patient’s hemodynamic status and kidney function.

Hematocrit levels provide insight into the patient's red blood cell concentration, which can signal fluid shifts due to the burn injury. In the initial stages post-burn, there is often a loss of plasma due to increased capillary permeability, leading to hemoconcentration, reflected in an elevated hematocrit. Monitoring urine output is equally vital as it helps assess renal perfusion and indicates the adequacy of fluid resuscitation; a minimum of 30-50 mL/hour is typically targeted in burn patients. Low urine output might indicate inadequate fluid resuscitation or worsening hypovolemia, signaling the need for adjustments in fluid therapy.

While blood pressure and heart rate are important vital signs that can suggest the patient's overall circulatory status, they are not specific indicators of fluid balance or resuscitation effectiveness in burn care. Serum electrolytes and temperature are also useful assessments, but they don’t directly evaluate the adequacy of fluid resuscitation like urine output and hematocrit do. Therefore, focusing on hematocrit and urine output is essential in