The emergency nurse admits a client who was rescued from a burning building. The client's arms and chest are covered with dry, leathery, charred skin that does not blanch. Which new prescription should the nurse implement first?

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11ecbb05_c9f7_97d4_b433_9fc439804754_MD0009_00 Burn injuries are caused by direct tissue damage from exposure to caustic (eg, thermal, chemical, electrical) sources. These injuries may be life-threatening, depending on the extent of tissue injury and organ damage. To prioritize the initial management of burn injuries, nurses should use the ABCs (ie, airway, breathing, circulation). Circulatory compromise is common after sustaining a burn, as extensive tissue injury combined with the systemic inflammatory response causes increased capillary permeability, fluid and electrolyte shifts, and decreased intravascular volume. These intravascular losses begin rapidly after a burn and may lead to hypovolemic shock and death. Therefore, the nurse should prioritize initiation of fluid resuscitation (Option C). (Option A) Although full-thickness burns destroy nerves and may be painless, clients with burns often have severe pain. However, pain is not life-threatening and may be treated after restoration of ABCs. (Option B) Burn injuries impair immune system function and skin integrity, increasing the risk for infection. Prevention of infection with topical antimicrobials (eg, bacitracin, silver sulfadiazine) is important. However, restoration of ABCs is the priority. (Option D) An escharotomy is a surgery involving incisions made through eschar (burned tissue) and is performed to prevent tissue ischemia and necrosis from impaired circulation. However, stabilizing circulatory status is the priority. Educational objective: Nurses should prioritize the initial management of burn injuries using the ABCs (ie, airway, breathing, circulation). Fluid administration, a life-saving measure for clients with burn injuries, stabilizes circulation and should be performed as soon as possible.

The Emergency Nurse Admits a Client Who Was Rescued from a Burning