Burns - fourth-degree
Structured condition card with NCLEX priority cues and nursing action focus.
Integumentary / Burns / Woundshigh priorityneeds review
Burns - fourth-degree
Also testable as: Deep full-thickness burn
Etiology / Pathophysiology
- Severe thermal, electrical, chemical, or prolonged injury extends into subcutaneous tissue, muscle, tendon, or bone.
- Deep tissue necrosis can cause massive fluid loss, rhabdomyolysis, compartment syndrome, and limb loss.
Medications
No specific medication class was seeded for this card.
Nursing actions
- Prioritize ABCs, cervical spine/trauma assessment if indicated, and rapid burn/trauma team activation.
- Monitor pulses, sensation, movement, urine output, potassium, CK, and renal function.
- Prepare for aggressive fluids, surgical management, debridement, grafting, or amputation pathway as ordered.
Complications
- Shock
- Rhabdomyolysis
- Hyperkalemia
- AKI
- Amputation
- Sepsis
NCLEX cues
- Electrical burn with small entrance wound can hide deep injury.
- Tea-colored urine suggests myoglobin.
- Absent distal pulse is emergency.
Memory hooks
- Fourth-degree goes beyond skin.
Labs / Diagnostics
- CK
- Potassium
- Creatinine
- Urine color/output
- Continuous cardiac monitoring for electrical burns
Review notes
- Supplemental wife-requested study card. Use for NCLEX review only and verify against school materials, ATI/NCLEX review sources, current orders, and facility policy.