A 26-Year-Old Man in the Burn Unit Is Being Evaluated

question 378

Multiple Choice

A 26-year-old man in the burn unit is being evaluated for nutritional needs.  The patient was admitted 12 hours ago after the trash he was burning exploded, causing partial- and full-thickness burns to the face, the anterior chest and abdomen, and both upper extremities.  He has been receiving IV crystalloid resuscitation titrated to an adequate urine output, and his burns have undergone initial debridement and dressing with topical antimicrobial ointment.  Temperature is 37.6 C (99.7 F) , blood pressure is 132/86 mm Hg, and pulse is 100/min.  The patient is mildly sedated but arousable.  Burn dressings are intact, with some serous drainage, and the abdomen is soft and nondistended.  Which of the following is the most appropriate management of this patient's nutrition?

• A)Dextrose-containing fluids now
• B)Enteral nutrition after 72 hours
• C)Enteral nutrition now
• D)Parenteral nutrition after 72 hours
• E)Parenteral nutrition now

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