Which of the following would indicate the need to increase fluids beyond what is recommended for fluid resuscitation?
A) Myoglobin in the urine
B) Increase in antidiuretic hormone (ADH)
C) Elevation of blood glucose levels
D) Hypernatremia
A
Feedback:
Myoglobin from muscle tissue destruction is transported to the kidneys for excretion and can cause tubular necrosis and acute renal failure. Increase in fluid intake until urine output clears is recommended in serious burns. An increase in ADH release is expected as the body tries to prevent hypovolemic shock. Elevation in glucose levels occurs when the adrenal cortex is stimulated. Sodium levels rise in response to aldosterone levels, which directly leads to peripheral edema.
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