A patient is brought to the emergency department after a house fire.He fell asleep with a lit cigarette,and the couch ignited.TBSA burn is estimated at 25% deep partial-thickness burns to areas of the chest,back,and left arm and 20% full-thickness burns to the right arm,right upper leg,and areas on the face.The patient is now in the intensive care burn unit with a heart rate of 140 beats/min,a urine output of 25 mL/hr,and clear lung sounds.The patient's symptoms are most likely attributable to

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The rate of fluid administration is adjusted according to the individual's response,which is determined by monitoring urine output,heart rate,blood pressure,and level of consciousness.Meticulous attention to the patient's intake and output is imperative to ensure that he or she is appropriately resuscitated.Under-resuscitation may result in inadequate cardiac output,leading to inadequate organ perfusion and the potential for wound conversion from a partial-thickness to full-thickness injury.Over-resuscitation may lead to moderate to severe pulmonary edema; to excessive wound edema causing a decrease in perfusion of unburned tissue in the distal portions of the extremities; or to edema inhibiting perfusion of the zone of stasis,resulting in wound conversion.

A Patient Is Brought to the Emergency Department After a House