A client arrives in the Emergency Department with a deep, full-thickness burn over the anterior surface of both upper legs. Which priority intervention should the nurse implement?

A client arrives in the Emergency Department with a deep, full-thickness burn over the anterior surface of both upper legs. Which priority intervention should the nurse implement?

• A. Start IV antibiotics.
• B. Administer tetanus immunization.
• C. Give IV analgesia.
• D. Give an IV bolus of normal saline.

Answer: (D)

In burn injuries, the immediate priority is fluid resuscitation because large burns cause rapid loss of intravascular volume from damaged skin and increased capillary permeability, risking hypovolemic shock. A deep full-thickness burn covering a substantial body area—such as the anterior surfaces of both thighs, which totals around 18% TBSA—triggers significant fluid shifts, so giving an IV bolus of normal saline helps rapidly restore circulating volume and stabilize perfusion while ongoing resuscitation is planned. Analgesia and tetanus vaccination are important parts of care, but they don’t address the critical, life‑threatening fluid loss first. Prophylactic antibiotics aren’t started routinely in the immediate resuscitation unless there’s evidence of infection.

In burn injuries, the immediate priority is fluid resuscitation because large burns cause rapid loss of intravascular volume from damaged skin and increased capillary permeability, risking hypovolemic shock. A deep full-thickness burn covering a substantial body area—such as the anterior surfaces of both thighs, which totals around 18% TBSA—triggers significant fluid shifts, so giving an IV bolus of normal saline helps rapidly restore circulating volume and stabilize perfusion while ongoing resuscitation is planned. Analgesia and tetanus vaccination are important parts of care, but they don’t address the critical, life‑threatening fluid loss first. Prophylactic antibiotics aren’t started routinely in the immediate resuscitation unless there’s evidence of infection.