Type of shock seen in burn cases-

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Medical Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Severe burns cause damage to capillaries, leading to a massive increase in their permeability.
This allows large amounts of plasma, proteins, and electrolytes to leak from the blood vessels into the surrounding tissues, a phenomenon known as third-spacing.
This significant loss of fluid from the circulatory system results in a decreased circulating blood volume (hypovolemia).
This state of low blood volume leads to inadequate tissue perfusion, which defines hypovolemic shock. It is the most immediate and life-threatening complication in major burns.

Option A: Cardiogenic shock is caused by the heart's failure to pump blood effectively (pump failure). While severe burns can put stress on the heart, the primary and initial cause of shock is massive fluid loss, not pump failure.
Option C: Neurogenic shock results from a loss of sympathetic nervous system tone, which causes widespread vasodilation and blood pooling. This is a distributive type of shock and is not caused by the fluid shifts seen in burns.
Option D: This option is incorrect because a specific and well-defined type of shock, hypovolemic shock, is the hallmark of the early phase of major burn injuries.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of shock in burn injuries as background academic context rather than a clinical decision trigger.
Nurses play a critical role in managing burn shock by initiating and monitoring aggressive fluid resuscitation, often guided by formulas like the Parkland (Baxter) formula.
The single best indicator of adequate fluid resuscitation in a burn patient is urine output. Nurses must monitor this hourly, aiming for 0.5-1 mL/kg/hr in adults.
Continuous monitoring of vital signs (heart rate, blood pressure), mental status, and peripheral perfusion is essential to assess the patient's response to therapy.

How to Approach the Question

First, identify the key concepts in the question stem: 'shock' and 'burn cases'.
Recall the primary physiological consequence of a severe burn injury. The main problem is the massive loss of plasma fluid from damaged blood vessels.
Next, review the definitions of the types of shock listed in the options.
Cardiogenic shock is pump failure. Neurogenic shock is a loss of vascular tone. Hypovolemic shock is a loss of volume.
Match the primary problem in burns (fluid volume loss) with the correct definition.
The loss of plasma volume directly corresponds to the definition of hypovolemic shock, making it the correct answer.

Concept Tested & Keywords

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E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 1 (1-214) p. 194-196

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 143-145