A client was rushed to the emergency department after sustaining burn injuries to their anterior trunk fully 8 hours ago. The client weighs 220 lbs and has been given their initial fluid bolus dose. At what rate per hour should the nurse set the IV pump for the remaining 16 hours? (Round to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["225"]

4 mL × body weight (kg) × % total body surface area (TBSA) burned = total fluid requirement in the first 24 hours

Half of this volume is given in the first 8 hours post-burn (from the time of injury).

The remaining half is given over the next 16 hours.

Step 1: Convert weight from pounds to kilograms
220 lbs ÷ 2.2 = 100 kg

Step 2: Determine % TBSA burned
anterior trunk burns, which corresponds to 18% TBSA (anterior trunk is about 18%).

Step 3: Calculate total fluid volume for 24 hours
4 mL × 100 kg × 18 = 7200 mL total in 24 hours

Step 4: Calculate remaining fluid to give over the next 16 hours
Half (first 8 hours) = 7200 ÷ 2 = 3600 mL (already given)
Remaining 16 hours = 3600 mL

Step 5: Calculate the hourly rate
3600 mL ÷ 16 hours = 225 mL/hour

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. In the compensatory stage of shock, blood pressure is usually maintained within normal limits due to vasoconstriction and increased cardiac output.
B. A heart rate of 160/min is excessively high and more typical of the progressive stage of shock.
C. Hypokalemia is not a typical finding specific to the compensatory stage of shock.
D. Mottled skin usually occurs in the later stages of shock due to poor perfusion, not during compensation.

A. Metabolic alkalosis B. Hypokalemia C. Elevated BUN D. Hypercalcemia

Correct Answer is C

Explanation

A. Acute kidney injury (AKI) typically causes metabolic acidosis, not alkalosis, due to impaired acid excretion.
B. AKI often results in hyperkalemia because the kidneys cannot excrete potassium effectively.
C. Elevated BUN is expected in AKI due to decreased kidney filtration and accumulation of nitrogenous waste.
D. Hypocalcemia, not hypercalcemia, is more common in AKI due to impaired vitamin D activation and phosphate retention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings should the nurse expect during this stage as the client's body compensates successfully?

Correct Answer is A

Explanation

A nurse is monitoring a client who has acute kidney injury. Which of the following laboratory findings should the nurse expect?

Correct Answer is C

Explanation

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