Final answer:
The patient's ongoing swelling and signs of dehydration after a severe burn likely stem from an infection at the burn site, which exacerbates fluid loss on top of the direct effects of the burn injury.
Step-by-step explanation:
Explanation for Dehydration in a Burn Injury Patient
The most likely explanation for the patient's swelling not being under control and the signs of dehydration is infection at the burn site. Burns can lead to a massive loss of fluid due to the damage of skin cells, making the skin more susceptible to infection.
An infection can exacerbate fluid loss, further contributing to dehydration. Despite being treated with intravenous fluids to offset dehydration, if infection ensues, the patient’s condition can deteriorate as the body's demand for fluids increases. Moreover, secondary dehydration can occur as a result of electrolyte imbalances from fluid loss, contributing to intracellular edema and slowing of circulation.
Additional factors such as impaired kidney function can also contribute to ongoing dehydration by preventing the body from conserving water. However, in the context of severe burns, infection remains a significant risk and a potential cause of uncontrolled swelling and persistent dehydration symptoms despite ongoing treatment.
Burn patients are treated with intravenous fluids to offset dehydration, but the swelling may not be under control if the fluid intake is inadequate. Infection at the burn site can also contribute to the swelling and dehydration.