A client with severe burns is at risk for hypovolemic shock. Which physiological finding supports this assessment?

• A. Decreased rate of glomerular filtration
• B. Excessive blood loss through burned tissues
• C. Plasma proteins moving out of the intravascular compartment
• D. Sodium retention due to aldosterone

Answer: (C)

Burn injuries trigger a systemic inflammatory response that makes capillaries leak more. As a result, plasma proteins move out of the intravascular space into the interstitial tissues. This loss of plasma proteins lowers oncotic pressure inside vessels and pulls fluid along with them into the interstitial space (third-spacing). The fluid shift reduces the circulating blood volume, which can decrease venous return and cardiac output, setting the stage for hypovolemic shock. Seeing plasma proteins escape from the bloodstream is a direct sign of this intravascular volume loss from capillary leak, so it best supports the assessment of hypovolemic risk after severe burns. The other options describe related effects or compensatory responses but are not as direct indicators of the intravascular volume depletion caused by burn-induced capillary leak.