You are admitting a 20-month-old female 3 hours post partial-thickness scald burns. The burns are on the anterior torso and neck, the right upper extremity, and the right face. There are large blisters on the torso and upper extremities. In addition, splash marks on the left lower and upper extremities without blisters and intact skin. Using the rule of nines, you estimate the patient has 20% of the body surface burned. A 22G peripheral intravenous line is in the left arm, and 0.9% normal saline is infusing at 70 ml per hour. The transport team placed wet saline dressings before transport. The patient weighs 13.5 kg. Calculate the rate at which the patient's burn fluid resuscitation should be infused in the first 8 hours.
99.5 ml per hour.
35.5 ml per hour.
33.8 ml per hour.
67.5 ml per hour.
The Correct Answer is D
Choice A reason: A 99.5 ml/hour rate overestimates fluid needs for a 13.5 kg child with 20% burns. The Parkland formula (4 ml/kg/% burn) yields 1080 ml over 8 hours (540 ml first 8 hours ÷ 8 = 67.5 ml/hour), making this rate too high, risking fluid overload.
Choice B reason: A 35.5 ml/hour rate underestimates fluid resuscitation for a 13.5 kg child with 20% burns. The Parkland formula calculates 540 ml for the first 8 hours (4 × 13.5 × 20 ÷ 2), or 67.5 ml/hour, insufficient fluid risks hypovolemia and shock.
Choice C reason: A 33.8 ml/hour rate is too low for burn resuscitation in a 13.5 kg child with 20% burns. The Parkland formula gives 67.5 ml/hour (4 × 13.5 × 20 ÷ 2 ÷ 8), and under-resuscitation risks inadequate tissue perfusion, leading to organ failure.
Choice D reason: For a 13.5 kg child with 20% burns, the Parkland formula (4 ml/kg/% burn) calculates 1080 ml total (4 × 13.5 × 20), with half (540 ml) in the first 8 hours, or 67.5 ml/hour. This rate ensures adequate hydration, preventing shock while avoiding fluid overload.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Partial thickness burns, affecting the epidermis and dermis, are commonly caused by hot liquids, like scalds, in children. These burns cause blisters and pain due to thermal damage penetrating deeper skin layers, consistent with the described injury, making this the likely cause.
Choice B reason: Electrical burns often cause deeper, full-thickness burns due to high-energy current penetrating tissues, causing necrosis beyond the dermis. Partial thickness burns are less typical, as electrical injuries tend to damage underlying muscles and nerves, making this an unlikely cause.
Choice C reason: Flame burns typically cause full-thickness burns, destroying the epidermis and dermis due to intense heat. Partial thickness burns are less common, as flames often result in deeper tissue damage, making this a less likely cause compared to hot liquid scalds.
Choice D reason: Mild sunburns cause superficial burns, affecting only the epidermis with redness and minimal pain. Partial thickness burns involve deeper dermal layers with blistering, which sunburns rarely cause unless severe, making this an unlikely cause for the described burn depth.
Correct Answer is A
Explanation
Choice A reason: The Glasgow Coma Scale assesses cognitive status by evaluating eye-opening, verbal, and motor responses. It quantifies consciousness level after a head injury, detecting neurological impairment due to trauma. This non-invasive tool provides immediate data on brain function, guiding further diagnostic and treatment decisions.
Choice B reason: A CT scan identifies structural brain injuries, like hematomas, but does not directly assess cognitive function. It visualizes anatomical damage rather than real-time neurological status, making it secondary to tools like the Glasgow Coma Scale for immediate cognitive assessment post-injury.
Choice C reason: Blood work can detect metabolic or infectious causes of altered cognition but does not directly evaluate cognitive status. It may reveal secondary issues like hypoglycemia but lacks specificity for assessing brain function after a head injury, making it less relevant for this purpose.
Choice D reason: Monitoring intracranial pressure is critical in severe head injuries but requires invasive devices and does not directly assess cognitive status. It measures pressure dynamics, not consciousness or cognitive function, making it inappropriate for initial cognitive evaluation compared to the Glasgow Coma Scale.
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