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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Correct Answer is ["225"]

Explanation

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

A. Urinary output 25 mL/hr B. Difficulty swallowing C. Heart rate 122/min D. Pain of 6 on a scale of 0 to 10

Correct Answer is B

Explanation

A. Urinary output of 25 mL/hr is low and concerning but not immediately life-threatening compared to airway compromise.
B. Burns to the face, ears, and eyelids can cause airway edema and swelling that may rapidly progress to airway obstruction. Difficulty swallowing may indicate swelling of the airway or impending airway compromise, which requires immediate intervention.
C. Heart rate of 122/min indicates tachycardia, which is common in burn patients due to pain, stress, or hypovolemia but is not as urgent as airway concerns.
D. Pain level of 6 requires management but is not a priority over airway or circulatory issues.

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["225"]

Explanation

A nurse is caring for a client who has burns to his face, ears, and eyelids. The nurse should identify which of the following is the priority finding to report to the provider?

Correct Answer is B

Explanation

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