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    Ati Nur 213 Lifespan 3 Proctored Exam(Fundamental Exam)

    A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement?

    Explanation & Rationale

    A. Weight: Weight changes can occur due to fluid shifts and edema, but it is not a primary indicator of adequate fluid resuscitation. In burn patients, weight fluctuation may not reliably reflect the effectiveness of fluid replacement. B. Urine output: Urine output is closely monitored in burn patients for signs of fluid resuscitation adequacy. However, if urine output continues to decrease (instead of increasing), it suggests worsening kidney perfusion and fluid depletion. C. BP: In burn patients, low blood pressure is a sign of fluid loss and inadequate perfusion. While blood pressure will eventually improve with successful fluid resuscitation, a further decrease in BP would indicate worsening shock and fluid deficit, not adequate resuscitation. D. Heart rate: A decrease in heart rate would indicate that the body is no longer compensating for hypovolemia and shock. Tachycardia is a common response to fluid loss and hypotension in burn patients, and as fluid resuscitation is effective, the heart rate should begin to decrease toward normal levels.

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