When caring for a patient with electrical burns, which order should the nurse question?

In the context of caring for a patient with electrical burns, the infusion of lactated Ringer's solution (LR) at a rate of 25 mL/h should be questioned due to the specific needs of patients with significant burns, especially electrical burns. These patients are at risk for acute kidney injury (AKI) because of the potential for myoglobinuria, which can occur when muscle breakdown results from the electrical injury.

When managing patients with electrical burns, fluid resuscitation is crucial, and the typical rate for initial fluid administration is much higher, often around 1000 mL/h for the first 24 hours, depending on the extent of the burn and the patient’s overall condition. A rate as low as 25 mL/h would likely be insufficient in maintaining adequate blood volume and renal perfusion, which is critical for preventing kidney complications associated with muscle injury and myoglobin release.

The other orders complement the needs of a patient with electrical burns. Administering mannitol is indicated to help prevent or mitigate AKI by maintaining urine flow and helping to flush out nephrotoxins. Testing urine for myoglobulin is warranted to monitor for muscle breakdown. Sodium bicarbonate administration can help alkalinize the urine, reducing