The nurse manager of a burn unit is conducting education for newly hired nurses

Question

What factors would the manager point to as reducing the rate of survival among burn patients? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. History of substance abuse
2. Endocrine diseases
3. Renal disease
4. Cardiac disease
5. Previous burn injury

Answer 1

1,2,3,4
Rationale 1: Preinjury status is a major factor in an individual's ability to survive a burn injury. Patients who abuse substances are at risk for compromised health status.
Rationale 2: In the presence of endocrine abnormalities such as diabetes, the added insult of a burn injury exacerbates the disease and impacts wound healing and the immune response.
Rationale 3: The hypovolemia that occurs as a result of fluid shifts causes a decrease in renal blood flow and filtration rates, which increases the risk for renal failure.
Rationale 4: Previous cardiac disease increases the mortality rate because the added insult of burn injury is overwhelming. Stimulation of the sympathetic nervous system causes the release of catecholamines (epinephrine and norepinephrine), increases systemic vascular resistance, and thus increases cardiac workload.
Rationale 5: There is no specific reason that a person with a previous burn injury would have a lower chance of surviving a second burn injury.