DIET THERAPY AND BURNS
Fluid, electrolyte, and protein losses are tremendous from the burned surfaces. Edema at the burn site, failure to obtain satisfactory skin growth, atony of the gastrointestinal tract, vomiting, and diarrhea are frequently encountered. The excretion of large amounts of nitrogen, potassium, and other wastes places a tremendous load upon the kidneys. Large intakes of fluid are required to hold these wastes in solution and to replace body fluids.
Intravenous feedings including total parenteral nutrition are used until the patient is able to take oral feedings. When peristalsis is adequate tube feedings may be used instead of, or in addition to, oral feedings. A diet supplying 3000 to 5000 kcal and 150 gm or more of protein is usually needed. Up to 1.0 gm ascorbic acid is often prescribed, as are also supplements of the B-complex vitamins.
Burned patients are in severe pain and sometimes lose the will to live. The fear of scarring and loss of attractive appearance can be overwhelming. The hospital stay is long and costly, and there may be great concern about how bills can be paid. These patients require great emotional support. When they are able to eat, the nurse and dietitian must encourage the patient to do so, as well as to drink sufficient fluids to permit adequate excretion of wastes. The patient’s likes and dislikes, as well as tolerances for specific foods, must be taken into account when planning menus. Some patients will take oral supplements from commercial products better than those that are prepared in the hospital because they view these products as a specific prescription.
*172/234/5*
GENERAL HEALTH

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