OtherSources: 0, APAInstructions: This will be a reply to two discussion board articles by myfellow students. Differentiate between discussion board # 1 and#2. Each reply should be around 10-15 lines with 1-2 referenceseach. thanks Discussion board 1. The greatest risk with burns involves the decrease in the volumeof blood plasma, hypovolemia. This substantial fluid lossusually occurs within the first 24 hours after injury. In thefirst 8-12 hours, the fluid shifts from the intravascular spacesto the interstitial fluid compartments. These shifts and fluidlosses are caused by an increase in capillary permeabilityresulting in shifts of not only fluid, but protein andelectrolytes are also shifted out of the intravascularcompartment into the external environment or tissues. Signs andsymptoms of hypovolemic shock secondary to burns can includeanxiety, cold, confusion, low blood pressure, rapid pulse anddecrease urine output (McCance, H. & Huether, S. 2014). References Kaplan, L. & Pinsky, M. Medscape: system inflammatory responsesyndrome. August 2016. Retrieved from:McCance, H. & Huether, S. (2014). Pathophysiology: the biologicbasis for disease in adults and children. 7th ed. St. Louis, MI. Elsevier: Mosby. Discussion board #2 3. Consider the massive fluid shifts that occur in early acuteburn injury. Explain how and where the fluid shifts, and whatsigns and symptoms result from this shift. Luo et al. (2015) describes burn injuries as disruptinghomeostasis and resulting in increased capillary increased capillary permeability causes hypovolemia becausethere is a significant amount of fluid loss from the circulatingblood volume (McCance & Huether, 2014). Fluid begins to leakfrom the circulation and into the interstitial space as well asevaporate (Luo et al., 2015). Intravenous fluid is administeredsuch as lactated ringers to attempt to restore volume during thistime (McCance & Huether, 2014). Due to the decreased circulatingblood volume there is decreased cardiac output, vascularischemia, acute renal failure, cardiovascular collapse and thiscan sometimes lead to death (Luo et al., 2015). There isevaporative water loss due to loss of skin; the natural barrierto evaporation (McCance , 2014). Alterations in cellularmetabolism are also seen during a burn injury and that furtherresults in increased cell membrane permeability and this can beseen by the many electrolyte imbalances that occur (McCance , 2014). Burn shock describes the fluid shifts seen inacute burn injury as well as the cellular component (McCance , 2014). Urine output will begin to taper off or stopcompletely due to the hypovolemic state to conserve thecirculating volume (McCance & Huether, 2014). When the burnpatient is resuscitated by fluids it causes edema, which canultimately lead to airway obstruction and worsening pulmonaryedema, however, if the patient is not properly fluid resuscitatedit can result in death (McCance & Huether, 2014). Adequate fluidadministration will assist with urine output. Capillary integritytypically restores after 24 hours if adequate fluid resuscitationoccurred (McCance & Huether, 2014). Luo, Q., Li, W., Zou, X., Dang, Y., Wang, K., Wu, J., & Li, Y.(2015). Modeling Fluid Resuscitation by Formulating Infusion Rateand Urine Output in Severe Thermal Burn Adult Patients: ARetrospective Cohort Study. Biomed Research International,2015(508043), 1-8.doi:10.1155/2015/508043 McCance, K. L., & Huether, S. E. (2014). Pathophysiology: thebiologic basis for disease in adults and children (7th ed.). , MO:Elsevier Mosby.
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