In preparing a patient for the rehabilitation phase of burn management, which statement reflects understanding of discharge teaching following a 6-month hospitalization?
1. "I need to begin cutting back on calories to avoid weight gain."
2. "I should have regular osteoporosis screening."
3. "I will likely not tolerate cold weather anymore."
4. "I must avoid getting a flu shot this year."
2
Rationale 1: Hypermetabolism is sustained for 9 to 12 months following burn injury. The patient's weight should be monitored closely throughout the rehabilitation phase. The patient may still require supplemental enteral nutrition or high- caloric nutritional supplements to maintain a positive energy balance.
Rationale 2: "I should have regular osteoporosis screening" is correct and reflects understanding of discharge teaching. Large burn injuries have been associated with bone density losses and may be at increased risk for osteoporosis and pathologic fractures.
Rationale 3: Thermoregulation disturbances continue throughout the rehabilitation phase and the patient may experience heat intolerance.
Rationale 4: Following burn injury, there is an increased susceptibility to infection and appropriate precautions should be taken. This includes avoiding unnecessary exposure to people with colds or infections and maintaining up-to-date immunizations.
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