On the second day after severe burns, the patient is experiencing significant fluid loss through evaporation from open wounds caused by burns as well as third spacing into the tissues. Therefore, the most important patient problem to address this day is fluid volume deficit. Although the patient has respiratory failure, the patient is intubated and mechanically ventilated; this has been addressed. The paralytic ileus is a normal part of the pathophysiology of severe burns; the patient will be maintained on parenteral nutrition for quite some time. Acute pain is an important consideration for nursing care; however, complications from fluid volume deficit can lead to death if not appropriately managed.