Final answer:
For a patient with 45% total body surface area burns, an increase in potassium, or hyperkalemia, is an expected lab value change. Decreased blood pH due to metabolic acidosis and decreased hematocrit from fluid resuscitation may also be observed.
Step-by-step explanation:
A patient with a 45% total body surface area thermal burns is likely to have several lab value changes due to the burn injury. Expect to see an increase in potassium (hyperkalemia) as a result of cell destruction, where intracellular potassium leaks into the bloodstream. Other potential changes include a decreased pH of the blood, which indicates metabolic acidosis often seen in severe burns due to increased lactic acid and a decrease in bicarbonate as the body attempts to compensate for the fluid loss and cellular damage.
As the body responds to a burn injury, there can also be an expected increase in leukocytes, or white blood cells (leukocytosis), as a part of the inflammatory response. This is a normal reaction to the stress of injury and potential infection. Over time, patient monitoring including lab tests for pH, CO2 partial pressure (pCO2), bicarbonate (HCO3), potassium, and sodium will continue to guide the medical management of burn patients. Burn injuries can result in electrolyte imbalance, acid-base disturbances, and changes in renal and circulatory function.
Furthermore, burn patients may experience a decrease in hematocrit due to hemodilution from fluid resuscitation efforts. This would not typically be seen acutely but could develop as intravenous fluids are administered to combat the dehydration caused by the extensive burns and fluid losses.