spectrum comparison
Burn Phases Timeline: Emergent → Acute → Rehabilitative — Fluid Shifts, Priority Problems, Key Interventions
Burn priorities flip completely across phases — the massive fluid resuscitation that saves your patient in the first 48 hours can drown them once capillary integrity returns. Choosing the wrong intervention for the wrong phase (diuretics during emergent, aggressive fluids during acute) is a lethal mistake the NCLEX will test you on.
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Progression3 stages
Progression — 3 stages
Emergent (0–48 hr)
What happens- Capillary leak: fluid shifts to tissues
Key findings- Hypovolemic shock
- ↓ BP, ↑ HR, ↓ urine, ↑ Hct
Nursing focus- ★Parkland: 4 mL × kg × %TBSA
- Give ½ in first 8 hr from burn
- Large-bore IV + Foley
- Target urine 0.5–1 mL/kg/hr
Acute (48 hr–closure)
What happens- Fluid shifts back into vessels, diuresis
Key findings- Hypervolemia risk
- Hemodilution (↓ Hct)
- ★Infection/sepsis: #1 cause of death now
Nursing focus- Aseptic wound care
- Silver sulfadiazine
- High-calorie, high-protein diet
- Titrate IV fluids down
Rehabilitative
What happens- Wounds closed
- Focus shifts to function
Key findings- Hypertrophic scarring
- Contractures, body-image distress
Nursing focus- ROM, splinting, pressure garments
- OT/psych support
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Clinical Pearl
Emergent = fluid OUT, push fluid IN; Acute = fluid BACK, watch for overload and infection; Rehab = prevent contractures.
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