Which statement about electrolyte changes in burn injuries is true?

Which statement about electrolyte changes in burn injuries is true?

• A. Potassium is released from damaged cells leading to hyperkalemia
• B. Sodium increases in extracellular fluid causing hyponatremia
• C. Calcium shifts into cells causing hypocalcemia
• D. Chloride decreases causing metabolic alkalosis

Answer: (A)

In burns, the immediate problem comes from direct damage to cell membranes. When cells are damaged, their contents spill into the surrounding fluid, and potassium, which is mostly inside cells, is released into the extracellular space. That sudden leak raises the level of potassium in the blood, causing hyperkalemia in the early phase after injury. This is why the statement about potassium leaking from damaged cells leading to higher serum potassium is the best description of what happens right after a burn. It's useful to keep in mind how electrolyte balance can evolve: as fluids shift and diuresis begins, potassium can later become depleted, so levels may fall in the later phase. Other electrolyte changes in burns do occur—for example, edema from capillary leakage can be associated with shifts in sodium and water that can lead to hyponatremia, and calcium can fall due to sequestration in damaged tissue or altered binding, but these do not describe the primary early change as accurately. Chloride-related acid-base status is often impacted by resuscitation with large volumes of saline, typically contributing to acidosis rather than alkalosis.

In burns, the immediate problem comes from direct damage to cell membranes. When cells are damaged, their contents spill into the surrounding fluid, and potassium, which is mostly inside cells, is released into the extracellular space. That sudden leak raises the level of potassium in the blood, causing hyperkalemia in the early phase after injury. This is why the statement about potassium leaking from damaged cells leading to higher serum potassium is the best description of what happens right after a burn.

It's useful to keep in mind how electrolyte balance can evolve: as fluids shift and diuresis begins, potassium can later become depleted, so levels may fall in the later phase. Other electrolyte changes in burns do occur—for example, edema from capillary leakage can be associated with shifts in sodium and water that can lead to hyponatremia, and calcium can fall due to sequestration in damaged tissue or altered binding, but these do not describe the primary early change as accurately. Chloride-related acid-base status is often impacted by resuscitation with large volumes of saline, typically contributing to acidosis rather than alkalosis.