A nurse is caring for a client who has full-thickness burns over 75 The nurse should use which of the following methods to monitor the cardiovascular system?

Choice A rationale Pulmonary artery pressure monitoring via a Swan Ganz catheter provides detailed information about left ventricular function and pulmonary vascular resistance. While useful in complex critical care cases, it is an invasive procedure with significant risks like dysrhythmias or pulmonary infarction. For a standard burn patient with 75 percent coverage, central venous pressure is usually the initial preferred method to guide the massive fluid resuscitation required during the first 24 to 48 hours. Choice B rationale Auscultating blood pressure using a cuff is often inaccurate or impossible in patients with 75 percent full thickness burns. The presence of significant edema, or the fact that the burns may cover all four extremities, prevents the effective use of a standard sphygmomanometer. Even if a site is available, the massive fluid shifts and decreased peripheral perfusion during burn shock make non invasive cuff pressures unreliable for guiding life saving titration. Choice C rationale Obtaining a central venous pressure is the most effective way to monitor fluid volume status in a severely burned patient. Full thickness burns over 75 percent of the body cause massive capillary leak and hypovolemia. CVP monitoring allows the healthcare team to assess the pressure in the right atrium and vena cava, providing a direct measurement of preload. This ensures that fluid resuscitation is sufficient to maintain organ perfusion without causing fluid overload. Choice D rationale Palpating pulse pressure provides a general sense of stroke volume and arterial tone, but it is purely subjective and lacks the precision needed for a patient in critical condition. In a patient with extensive burns, peripheral pulses may be difficult to palpate due to edema or eschar formation. Relying on manual palpation is insufficient for the minute to minute hemodynamic monitoring required to manage the complex fluid requirements of major burn injuries. .