On admission to the burn unit, a client with an appropriate 25% total body surface area (TBSA) burn has the following initial laboratory results: Hct 59%, Hgb 19.2 mg/dL, Serum K 5.0 mEq/L and serum Na 150 mEq/L. Which action will the nurse anticipate taking now?

A. Type and crossmatch for a blood transfusion: Elevated hematocrit and hemoglobin in acute burns reflect hemoconcentration from plasma fluid loss, not true anemia. A blood transfusion is not indicated at this stage, as oxygen-carrying capacity is adequate and the priority is fluid resuscitation rather than correction of hemoglobin levels. B. Increase the rate of IV Lactated Ringers solution per doctors order: Burns involving 25% TBSA result in significant plasma and extracellular fluid loss due to capillary permeability. Elevated hematocrit (59%) and hemoglobin (19.2 mg/dL) indicate hypovolemia. Hypernatremia (150 mEq/L) reflects water loss exceeding sodium loss. Increasing isotonic fluid replacement, such as Lactated Ringer’s, is essential to restore intravascular volume and maintain perfusion. C. Continue to monitor the laboratory results: While ongoing lab monitoring is important, immediate intervention is required for hypovolemia and hemoconcentration in major burns. Waiting to act solely on labs could worsen tissue hypoperfusion, organ dysfunction, and shock. D. Monitor urine output every 8 hours: Accurate urine output is an important indicator of renal perfusion, but in acute burn resuscitation, hourly urine output monitoring is standard. Monitoring every 8 hours is insufficient for guiding fluid therapy and early recognition of hypovolemic complications in a high-risk burn patient.