12-23-2005, 01:18 PM
After suitable calculations have been made using the modified Parkland formula, a 70-kg man with extensive third-degree burns is receiving Ringer's lactate at the calculated rate, which happens to be 750 mL/hr. The infusion was started within 30 minutes of the time when the burn occurred. Over the next 3 hours, his urinary output is recorded as 15 mL, 22 mL, and 18 mL. It is verified that the Foley catheter is open and draining freely. The urine is dark yellow, without blood, and has a specific gravity of 1040 and a sodium concentration of 10 mEq/L. The patient's blood pressure is 100/70 mm Hg, his pulse is 98/min, and his central venous pressure is 2 cm H2O. On the basis of these findings, which of the following is the most appropriate next step in management?
A. Diuretics should be given
B. Fluid administration should continue at the present rate
C. The rate of fluid administration should be decreased
D. The rate of fluid administration should be increased
E. Treatment is needed for renal failure
A. Diuretics should be given
B. Fluid administration should continue at the present rate
C. The rate of fluid administration should be decreased
D. The rate of fluid administration should be increased
E. Treatment is needed for renal failure