Nokea
The nurse, in assessing the adequacy of a client's fluid replacement during the first 2 to 3 days following full- thickness burns to the trunk and right thigh, would be aware that the most significant data would be obtained from recording
Correct Answer: C
Rationale: Monitoring urinary output every hour is crucial in assessing the adequacy of fluid replacement in a client with full-thickness burns. Burn injuries can result in a significant loss of fluid and electrolytes due to increased capillary permeability and excessive fluid shift from the intravascular space to the interstitial space. Adequate fluid replacement is essential to maintain tissue perfusion, prevent hypovolemia, and support organ function. By closely monitoring the urinary output every hour, the nurse can assess renal perfusion, fluid balance, and the effectiveness of fluid resuscitation. A decrease in urinary output can indicate inadequate fluid replacement, while an increase may suggest fluid overload. This information is important in guiding adjustments to the fluid replacement therapy to ensure optimal outcomes for the client. Weights, blood pressure measurements, and assessment of peripheral edema are also important data to monitor in a burn client, but urinary output is the most significant indicator of fluid balance in