Mr. Davis is a 56-year-old man who was involved in a fire in his home. He was smoking a cigarette and fell asleep, dropping the cigarette and igniting the bed linens. He sustained full thickness burns over the upper half of his trunk and neck (anterior and posterior) and the posterior aspects of both upper arms. He also sustained superficial partial-thickness burns to his face and hands. He arrived at your burn unit 5 hours after injury. Labs were drawn. A foley catheter and NG tube were inserted in the ER. Assessment findings: Height is 72 inches, weight is 185 lbs. You auscultate wheezes in the patient’s lungs and he has a productive cough of a small amount of carbon-tinged sputum. Mr. Davis rates his pain at a “9” on a scale of 0-10. He denies pain at the chest, neck, back, and upper arms. Urine output has totaled 150 ml since the foley was inserted 2 hours ago. His foley is draining burgundy-colored urine. Mr. Davis is experiencing nausea, has faint bowel sounds, and his abdomen is distended. A nasogastric tube was inserted to low intermittent suction and is draining dark yellow-green liquid. His extremities are edematous making the pulses difficult to palpate. His blood pressure is 96/50, pulse 114 beats per minute, respirations are 24, and temperature is 100 degrees Fahrenheit.
The greatest initial threat to a patient with a major burn is hypovolemic shock. Using the above assessment: 1.
Do you think Mr. Davis is experiencing hypovolemic shock? If so, what data supports this? (2 points)
Yes, Mr. Davis is most likely experiencing hypovolemic shock, due to low blood pressure, increased heart rate, as well as an increase in respiratory rate.
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