The nurse is analyzing the labs for the patient brought to the emergency department by ambulance after a burn to the entire head, neck, bilateral anterior and posterior arms, and chest and abdomen. What lab findings immediately after the burn does the nurse most likely expect with this patient?
Explanation & Rationale
A. Sodium (Na+) 150 mEq/L: Hypernatremia may occur later if fluid losses are not replaced, but immediately after a major burn, sodium levels are typically normal or slightly decreased due to massive fluid shifts into the interstitial space (third spacing). Sodium is usually not elevated at this early stage. B. Potassium (K+) 6.2 mEq/L: Immediately after a severe burn, cellular injury and tissue destruction cause potassium to shift from the intracellular to the extracellular space, leading to hyperkalemia. This is an expected acute finding and poses a risk for cardiac dysrhythmias, making prompt monitoring essential. C. Hematocrit (Hct) 26%: Immediately post-burn, hemoconcentration is more common due to plasma loss from capillary leakage, so hematocrit usually rises rather than falls. A low hematocrit is not typical in the initial phase unless there is preexisting anemia or massive hemorrhage. D. Prothrombin Time (PT) 13 seconds: PT is usually unaffected immediately after a burn. Coagulopathy is not typically an acute concern unless extensive tissue injury progresses to later complications such as disseminated intravascular coagulation (DIC).