A nurse is caring for a client with 45% total body surface area (TBSA) thermal burns. During the emergent, initial phases of burn shock the nurse should closely monitor for which electrolyte imbalance?

A. Hypernatremia: Sodium levels typically decrease during the emergent phase due to fluid shifts and sodium movement into the interstitial space. Hypernatremia is not expected early in burn shock. B. Hyperkalemia: In the initial phase of major burns, damaged cells release potassium into the bloodstream, causing elevated serum potassium. This intracellular shift results in hyperkalemia, increasing the risk of cardiac arrhythmias. C. Hypokalemia: This is more common during the later phases of burn recovery, particularly during diuresis or with aggressive fluid replacement, not in the immediate emergent phase. D. Hypocalcemia: Hypocalcemia can occur in burn injuries, particularly in the later stages or in cases of very extensive burns, due to factors like decreased serum albumin (a calcium-binding protein) and calcium shifts. However, hyperkalemia poses a more immediate and life-threatening risk in the emergent phase.