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A 45-year-old male patient arrives at the emergency department with partial-thickness burns on his entire right arm, the front of his right leg, and the entire front of his torso. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA) burned?

54%

27%

45%

36%

Answer and Explanation

The Correct Answer is D

A. 54%. This percentage would be an overestimate based on the Rule of Nines.

B. 27%. This underestimates the TBSA affected based on the Rule of Nines.

C. 45%. This overestimates the TBSA.

D. 36%. Using the Rule of Nines:

Entire right arm = 9%
Front of right leg = 9%
Front of torso = 18%
Total TBSA = 9% + 9% + 18% = 36%

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Correct Answer is D

Explanation

A. The surgical dressing has a small amount of serosanguinous drainage. Light serosanguinous drainage is expected postoperatively and does not require immediate intervention.
B. The patient’s hemoglobin dropped from 12 g/dL to 10 g/dL within 24 hours postoperatively. A mild drop in hemoglobin postoperatively is expected due to blood loss during surgery. This does not require immediate intervention.
C. The patient reports mild discomfort at the surgical site and rates pain as 4/10 on a pain scale. Mild discomfort is expected and can be managed with prescribed analgesics.
D. The surgical extremity is cool to touch, pale, with weak pedal pulses compared to the contralateral limb. These findings indicate impaired circulation or vascular compromise, which could suggest compartment syndrome or arterial occlusion. Immediate intervention is required to prevent limb ischemia.

A. Apply an ice pack to the casted leg. B. Perform a neurovascular assessment. C. Provide reassurance to the client and parents. D. Explain the discharge instructions to the client and parents.

Correct Answer is B

Explanation

A. Apply an ice pack to the casted leg: Ice packs help with swelling and pain but are not the priority over assessing for neurovascular compromise.

B. Perform a neurovascular assessment. The priority action is to assess circulation, sensation, and movement (CSM) to rule out compartment syndrome, which is a limb-threatening complication. Any signs of compromised blood flow require immediate intervention.

C. Provide reassurance to the client and parents. Providing reassurance is important for emotional support but does not take priority over ensuring proper blood flow and nerve function in the affected limb.

D. Explain the discharge instructions to the client and parents. Teaching is essential but should be done after confirming that the limb is not at risk for serious complications.

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A 45-year-old male patient arrives at the emergency department with partial-thickness burns on his entire right arm, the front of his right leg, and the entire front of his torso. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA) burned?

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