Calculate the total intravenous fluids infused in 24 hrs for a 147.4-lb client with a 31.5% TBSA burn and receiving insulin 5 units/hr. The concentration of insulin is 100 units in 100 mL normal saline.
8750mL
8000mL
8562mL
8502 mL
The Correct Answer is C
To calculate the total intravenous fluids infused in 24 hours for a burn client, use the Parkland formula.
- Calculate Fluid Resuscitation Volume (Parkland Formula)
Convert client's weight from pounds (lb) to kilograms (kg).
Client weight = 147.4 lb / 2.2 lb/kg
= 67 kg.
- Calculate the total fluid volume needed for the first 24 hours using the Parkland formula.
Parkland Formula = 4 mL × client weight (kg) × % TBSA burned
Total fluid volume (24 hrs) = 4 mL × 67 kg × 31.5%
= 8442 mL.
- Calculate Insulin Infusion Volume in 24 hours
Concentration of the insulin solution = 100 units / 100 mL
= 1 unit/mL.
- Calculate the volume of insulin solution infused per hour.
Infusion rate = 5 units/hr
Volume infused per hour (mL/hr) = Desired units/hr / Concentration (units/mL)
= 5 units/hr / 1 unit/mL
= 5 mL/hr.
- Calculate the total volume of insulin solution infused in 24 hours.
Total insulin volume (24 hrs) = Volume infused per hour (mL/hr) × 24 hours
= 5 mL/hr × 24 hours
= 120 mL.
- Calculate Total Intravenous Fluids Infused in 24 hours
Total IV fluids = Total fluid resuscitation volume + Total insulin volume
= 8442 mL + 120 mL Total IV fluids
= 8562 mL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["31.5"]
Explanation
- Calculation of the TBSA according to the rule of 9s:
Anterior Trunk: 18%
Right Arm: 9% (full arm on both posterior and anterior aspects)
Left Arm: 4.5% (only one half, from the elbow to the fingers in both anterior and posterior sides).
Then TBSA = 18 + 9 + 4.5
= 31.5%.
Correct Answer is D
Explanation
A. Increase in the heart rate from 88 to 90/min: A heart rate increase of 2/min is not significant to indicate hypovolemic shock. In the early stages of hypovolemic shock, a more pronounced increase in heart rate is expected as a compensatory mechanism for low blood volume.
B. Increase in the temperature from 99.5°F to 100°F: A slight increase in temperature is common postoperatively and is generally not indicative of hypovolemic shock. A more concerning sign would be a fever that is significantly elevated or a rapid temperature change in combination with other symptoms.
C. Decrease in the respiratory rate from 20 to 16/min: A decrease in respiratory rate is not typically a sign of hypovolemic shock. In shock, respiratory rate often increases as the body compensates for decreased oxygen perfusion.
D. Decrease in the urinary output from 50 mL to 30 mL per hour: As the body experiences decreased perfusion due to blood loss, the kidneys are less able to filter and excrete urine. A decrease in urinary output indicates poor renal perfusion, which is a sign of shock.
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