What complication should the nurse monitor for in a child with partial- and full-thickness burns over 30% of the body during the first 48 hours?

In children with partial- and full-thickness burns covering a significant area of the body, such as 30% or more, the risk of developing shock is a critical concern within the first 48 hours following the injury. This is primarily due to the loss of large amounts of fluid and plasma that occurs as a result of extensive skin damage. The burns compromise the body's ability to maintain fluid balance, leading to hypovolemia, which can quickly progress to shock.

The pathophysiology behind this type of shock is rooted in the body's response to burn injury. The initial inflammatory response causes increased capillary permeability, allowing fluid to leak from the vascular system into the surrounding tissues, resulting in edema. If fluid replacement is not managed appropriately, it can lead to reduced cardiac output and perfusion to vital organs, causing shock.

Monitoring for shock is essential in the acute phase of burn management, as it is a life-threatening condition that requires immediate intervention. The nurse must be vigilant in assessing vital signs, urine output, and other clinical indicators of perfusion status during this critical period.