A male client who weighs 90 kg is admitted to the emergency department with full thickness burns to 45% of his total body surface area (TBSA). The burns occurred at 1000. At 1200, the nurse uses the prescribed protocol for burns fluid resuscitation to calculate the total fluid volume for the first 24 hours. The infusion pump should be set to deliver how many mL/hour during the first 8 hours? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
The Correct Answer is ["1350"]
Rationale:
Fluid resuscitation rate using the Parkland formula:
- Calculate the total fluid volume needed for the first 24 hours.
The Parkland formula: 4 mL × client weight (kg) × % TBSA burned.
Client weight = 90 kg
TBSA burned = 45%
Total fluid volume = 4 mL × 90 kg × 45 = 16,200 mL
- Determine the amount of fluid to be given in the first 8 hours.
According to the Parkland formula, half of the total fluid volume is administered in the first 8 hours from the time of the burn injury.
Fluid for first 8 hours = 16,200 mL / 2
= 8,100 mL
- Calculate the infusion rate for the first 8 hours.
The burn occurred at 1000. The nurse arrives at 1200. This means 2 hours have already passed since the burn occurred within the initial 8-hour period.
Remaining time in the first 8 hours = 8 hours - 2 hours
= 6 hours.
Infusion rate (mL/hour) = Fluid for remaining first 8 hours / Remaining time in first 8 hours
= 8,100 mL / 6 hours
= 1350 mL/hour.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["83"]
Explanation
Rationale:
Total volume to be infused = 500 mL.
Infusion time in minutes = 2 hours × 60 minutes/hour
= 120 minutes.
Drop factor of the IV administration set = 20 gtt/mL.
- Calculate the flow rate in drops per minute (gtt/min).
Flow rate (gtt/min) = (Total volume (mL) × Drop factor (gtt/mL)) / Infusion time (min)
= (500 mL × 20 gtt/mL) / 120 min
= 10000 / 120 gtt/min
= 83.333... gtt/min.
- Round the answer to the nearest whole number.
= 83 gtt/min
Correct Answer is D
Explanation
A. "Haven't you been feeding according to recommended daily allowances for children?": This response implies blame and lacks sensitivity. It doesn't acknowledge the child’s underlying medical condition that may affect growth.
B. "Does your child seem mentally slower than his peers also?": Intellectual development is unrelated to height/weight percentile in children with congenital heart disease unless there are neurological complications, which haven't been indicated.
C. "You should not worry about the growth tables. They are only averages for children.": While growth charts are averages, they are clinically significant, especially for identifying underdevelopment in children with chronic illnesses.
D. "The smaller size is probably due to the heart disease.": Chronic hypoxia and increased metabolic demands in congenital heart disease often contribute to poor weight gain and growth delay, making this the most informative and empathetic response.
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