Short Answer 
The nurse must first assess the patient’s fluid needs due to severe burns, monitor for complications like dehydration and renal dysfunction, and consult with a physician if urine output remains low or complications arise to adjust treatment accordingly. Prompt monitoring and collaboration with the physician are crucial for the patient’s care.
Step 1: Assess Fluid Needs
The first step for the nurse is to assess the patient’s current fluid needs based on their condition. Since the patient has severe burns covering 32% of their body, the typical daily urine output should be around 473 ml. With only 15 ml produced in the last hour, this indicates a potential issue. The nurse should calculate the appropriate fluid resuscitation rate to ensure the patient receives enough fluids.
Step 2: Monitor for Complications
Next, it’s crucial to monitor the patient for signs of complications related to dehydration and renal dysfunction. The nurse should look for symptoms such as inadequate perfusion (e.g., low blood pressure, rapid heart rate) and other renal function indicators like decreased urine output. This monitoring is essential to identify any worsening of the patient’s condition promptly.
Step 3: Consult with the Physician
Finally, if the urine output remains low and signs of complications arise, the nurse should consult with the physician immediately. This collaboration may involve discussions about adjusting the fluid resuscitation rate or administering diuretics if there’s a risk of fluid overload. Working closely with the physician ensures that the patient receives the best possible care to address their critical needs.