Question

A burn client has been having 1% silver sulfadiazine applied to burns twice a day for the past 3 days. Which laboratory abnormality indicates that the client is experiencing a side or adverse effect of this medication?

a.Serum sodium of 120 mEq/L (120 mmol/L)
b.Serum potassium of 3.0 mEq/L (3.0 mmol/L)
c.White blood cell count of 3000 mm3 (3 × 109/L)
d.pH 7.30, PaCO2 of 32 mm Hg (32 mmHg), HCO3- of 19 mEq/L (19 mmol/L)

Answer 1

The adverse effect of 1% silver sulfadiazine in a burn patient is demonstrated by leukopenia, evidenced by a white blood cell count of 3000 mm³. Leukopenia can increase the risk of infection and is due to the bone marrow suppressive effect of the medication.

Step-by-step explanation:

The laboratory abnormality that indicates a side or adverse effect of 1% silver sulfadiazine in a burn patient is a white blood cell count of 3000 mm3 (3 × 109/L). This condition, known as leukopenia, can occur due to the suppressive effect that silver sulfadiazine has on the bone marrow, leading to decreased production of white blood cells. Symptoms of leukopenia might include an increased risk of infection.

Hyponatremia (serum sodium of 120 mEq/L), hypokalemia (serum potassium of 3.0 mEq/L), and metabolic acidosis (represented by pH 7.30, PaCO2 of 32 mm Hg, and HCO3- of 19 mEq/L), while critical conditions, are not directly associated with the administration of silver sulfadiazine. Therefore, in this scenario, the significant drop in white blood cell count is the indicator of an adverse reaction to the medication being applied to the burn areas.

It is also worth noting that a burn injury itself can often lead to leukocytosis, which is an increased white blood cell count, as part of the body's inflammatory response to injury. However, in the context of using silver sulfadiazine, a drop below normal leukocyte levels would be cause for concern.