Burn Injury

URINALYSIS:

- To screen urine for multiple substances such as infection, blood, sugar, bilirubin, urobilinogen,
nitrates, and protein to assist in diagnosing disorders such as renal and liver disease as well as
assess hydration status. The results can provide valuable information regarding the overall
health of the patient and the patient’s response to disease and treatment
- In the case scenario, urinalysis was ordered due to possible kidney alteration secondary to burn
injury. Kidney function may be altered as a result of decreased blood volume post-burn injury
due to the compensatory response to intravascular volume loss. If there is a destruction of RBC
results in free hemoglobin in the urine. If muscle damage occurs, myoglobin is released from the
muscle cells and excreted by the kidneys causing the urine to be red. Additionally, if there is
inadequate blood flow through the kidneys caused by the hemoglobin and myoglobin occluding
the renal tubules, acute tubular necrosis and acute kidney injury will occur.

CBC

- To evaluate numerous conditions involving red blood cells, white blood cells, and platelets. This
test is also used to indicate inflammation, infection, and response to chemotherapy. The CBC
can evaluate your overall health and detect a variety of diseases and conditions, such as
infections, anemia and leukemia. https://labtestsonline.org/tests/complete-blood-count-cbc
- One of the complications in burn injury includes wound infection, bacterial infections or other
infection. Other than that, at the time of burn injury, some red blood cells may be destroyed and
others damaged resulting to anemia. Abnormalities in coagulation, including thrombocytopenia
and prolonged clotting in prothrombin times, may also occur.

ECG

- 4862
- is used to diagnose dysrhythmias, conduction abnormalities, and chamber enlargement, as well
as myocardial ischemia, injury, or infarction. It can also suggest cardiac effects of electrolyte
disturbances (high or low calcium and potassium levels) and the effects of antiarrhythmic
medications pg, 1908
- When a burn injury occurs, an immediate decrease in cardiac output may occur which can lead
to loss of plasma volume. And due to vasoconstrictive compensatory responses secondary to
plasma volume loss, the workload of the heart and oxygen demand increases. As fluid loss
continues due to capillary leakage, and vascular volume decreases, cardiac output continues to
decrease and the blood pressure drops which then precedes to burn shock or hypovolemic
shock. Burn shock is initially a type of hypovolemic shock. Furthermore, physiologic changes to
the cardiovascular are cardiac depression, edema, and hypovolemia.

Reference:

Brunner and Suddarth’s., (2018). Medical Surgical Nursing. Singapore: Elsevier

Davis’s., (2015). Comprehensive Handbook of Laboratory & Diagnostic Tests with Nursing
Implications. 6th Edition
Complete blood count (CBC) - understand the Test & Your Results. Lab Tests Online. (2021, June 18).
Retrieved October 27, 2021, from https://labtestsonline.org/tests/complete-blood-count-cbc.