Managing Diarrhea in a Client with Open Burn Wounds: Nurse’s Best Actions and Considerations

Caring for clients with open burn wounds involves vigilance and prompt response to various health concerns that may arise during the healing process. In this article, we will address a scenario where a client with open burn wounds develops diarrhea, exhibits a below-normal temperature, and has a low white blood cell count. We will explore the nurse’s best actions and considerations for effective patient care in this complex situation.

Challenges in Burn Wound Management

Burn wounds can significantly compromise the body’s ability to regulate temperature, fight infections, and maintain overall health. Clients with open burn wounds require meticulous care and close monitoring to address potential complications promptly.

The Scenario

Imagine a client who is undergoing treatment for open burn wounds and suddenly develops diarrhea. In addition to this gastrointestinal symptom, the client’s condition is further complicated by a below-normal body temperature and a white blood cell count of 4000/mm3. These abnormalities raise concerns about infection and overall health.

Nurse’s Best Action

The nurse’s response should be comprehensive, focusing on assessing the client’s condition, addressing immediate concerns, and collaborating with the healthcare team. The best course of action might include the following steps:

  1. Assessment: Begin by assessing the client’s overall condition, paying close attention to vital signs, including body temperature, heart rate, and respiratory rate. Examine the burn wounds for any signs of infection, such as increased redness, swelling, warmth, or purulent discharge.
  2. Stool Sample: Collect a stool sample to send for laboratory analysis. Diarrhea can be caused by various factors, including infection, medications, or changes in diet. Identifying the underlying cause is crucial for appropriate intervention.
  3. Isolation Precautions: Until the cause of diarrhea is determined, consider implementing isolation precautions to prevent the potential spread of infection to others, especially if there is a concern about infectious diarrhea.
  4. Fluid and Electrolyte Assessment: Assess the client’s hydration status and electrolyte balance, as diarrhea can lead to fluid and electrolyte imbalances. Intravenous (IV) fluids may be necessary to maintain hydration.
  5. Infection Control: Given the client’s low white blood cell count and the risk of infection in burn wounds, strict infection control measures should be in place. This includes wound care, antibiotic therapy if indicated, and meticulous hand hygiene.
  6. Collaboration with the Healthcare Team: Communicate the client’s condition and assessment findings with the healthcare team, including the attending physician and infectious disease specialist if necessary. Collaboration ensures a multidisciplinary approach to diagnosis and treatment.
  7. Temperature Management: Pay particular attention to temperature regulation. Clients with burn injuries are susceptible to hypothermia, so warming measures may be required to maintain normal body temperature.
  8. Medication Review: Review the client’s medication list to identify any medications that may contribute to diarrhea or have potential interactions with new medications that may be prescribed.
  9. Educate the Client: If appropriate, educate the client about the importance of hand hygiene, isolation precautions (if implemented), and the need to report any changes in symptoms promptly.

Considerations for Infection

In the context of open burn wounds and a low white blood cell count, the nurse should be vigilant about the possibility of infection. Burn wounds are vulnerable to infection due to the loss of the skin’s protective barrier. Timely identification and treatment of infections are critical to prevent complications and support wound healing.


Diarrhea in a client with open burn wounds, combined with a below-normal temperature and low white blood cell count, warrants a thorough assessment and a multidisciplinary approach to care. The nurse’s actions should prioritize patient safety, infection control, and addressing potential underlying causes of diarrhea. Collaboration with the healthcare team is essential for accurate diagnosis and the implementation of an effective treatment plan tailored to the client’s unique needs.


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