What should a nurse expect regarding urine output in a patient with severe burns during the first 24-48 hours?

In the context of severe burns, patients typically experience reduced urine output during the first 24-48 hours due to several physiological responses to the injury. Initially, burns lead to a significant loss of intravascular volume as a result of fluid shift from the vascular space to interstitial tissues, primarily due to increased capillary permeability. This phenomenon is known as burn shock. As a result, the body activates compensatory mechanisms, such as the release of antidiuretic hormone (ADH) and aldosterone, attempting to conserve fluid and maintain blood pressure.

During this time, renal perfusion is often compromised, which can lead to oliguria, or decreased urine output. This is a critical period where the kidneys may receive less blood flow, and thus, the urine volume is expected to be lower. The decreased urine output serves as an indicator of the body’s response to a state of hypovolemia and potential shock.

Monitoring urine output in burn patients is essential for assessing the adequacy of fluid resuscitation and renal function, making awareness of this initial decrease crucial for nursing care. Therefore, the expectation of reduced urine output aligns with the pathophysiological processes occurring in severe burn cases during this early post-injury phase.