Final answer:
The nurse should be aware that the risk of hypermetabolism in a young child with extensive burns will necessitate increased caloric intake through enteral feedings. Nasogastric tube feedings are typically used unless there are contraindications, and careful monitoring for gastrointestinal complications is essential.
Step-by-step explanation:
In a young child with burns covering 40% of the total body surface area, enteral feedings are critical for meeting the increased nutritional demands due to hypermetabolism. These feedings can be administered through a nasogastric tube unless contraindicated by other factors, such as gastrointestinal injury or dysfunction. Contrary to the notion that enteral feedings would reduce the risk of infection due to altered gastrointestinal function, burn patients are actually at a higher risk of infection due to the loss of skin integrity.
It is essential to monitor for signs of paralytic ileus, a condition where peristalsis is halted, which would necessitate a temporary stop of enteral feeding. This careful monitoring ensures the patient's gastrointestinal tract is functioning properly and can absorb the nutrients provided.
Specifically addressing the student's question, the nurse should know that option D) 'Risk of hypermetabolism will require increased caloric intake' is correct. It is important to provide enough calories to support the healing process and counter the increased metabolic demands caused by the burn injury.