1. Impaired Skin Integrity related to thermal injury and destruction of skin layers as evidenced by burns, blistering, open areas, or eschar.
2. Acute Pain related to tissue injury, burn wound care, and procedures as evidenced by crying, guarding, irritability, increased heart rate, or pain-score report.
3. Risk for Infection related to loss of the protective skin barrier, invasive devices, and wound contamination.
4. Deficient Fluid Volume related to increased capillary permeability and evaporative fluid loss secondary to major burns as evidenced by decreased urine output, tachycardia, dry mucosa, poor perfusion, or hypotension.
5. Risk for Ineffective Airway Clearance / Impaired Gas Exchange related to smoke inhalation, facial or neck burns, airway edema, or respiratory secretions.
   • This is high priority when there are facial burns, soot, hoarseness, stridor, or respiratory distress.
6. Ineffective Thermoregulation related to loss of skin barrier and increased heat loss as evidenced by low body temperature or cool extremities.
7. Imbalanced Nutrition: Less Than Body Requirements related to hypermetabolic response, increased protein needs, pain, or poor oral intake.
8. Impaired Physical Mobility related to pain, edema, bulky dressings, splinting, or risk of contractures.
9. Anxiety/Fear related to unfamiliar environment, pain, separation from parents, and frightening procedures as evidenced by crying, withdrawal, restlessness, or clinging to caregivers.
10. Disturbed Body Image related to visible wounds, scars, dressings, or altered appearance, especially in older children and adolescents.
11. Deficient Knowledge (Parents/Caregivers) related to unfamiliarity with burn wound care, medicines, nutrition, infection warning signs, and prevention of contractures.

Example priority nursing diagnosis statement