Parkland Formula Questions for BURNS Fluid Resuscitation with Rule of NINE

Knowing that the adult client weighs 174.74 lbs and has a TBSA that is 36% use the Parkland Formula calculate the fluid to be infused over the first 24 hours after the burn injury: ____________________ mL

11,376 mL in 24 hours 4mL x 36% x 79 kg= 11,376

Calculate the burn injury using the Rule of Nines: An adult client came into the ED with burns initially affected the client's entire face (anterior half of the head) and the upper half of the anterior torso, and there were circumferential burns to the lower half of both arms. The client's clothes caught on fire, and the client ran, causing subsequent burn injuries to the posterior surface of the head and the upper half of the posterior torso. 1. 36% 2. 24% 3. 18% 4. 48%

1: 36% The anterior half of the head: 4.5% The upper half of the anterior torso: 9% The lower half of both arms: 9% The subsequent burn included the posterior half of the head: 4.5% The upper half of posterior torso: 9%

An adult patient is brought into the ED after suffering from third degree burns in an explosion. The patient has burns on approximately 42 percent of his body. The nurse weighs the patient and notes that he weighs 78 kg. A: Calculate the rate of IV fluid this patient must receive in the first 24 hours using the Parkland formula B: What is the mL/hr to be infused in the first 8 hours after arrival.

A: 13,104 mL in the first 24 hours B: 819 mL/hr for the first 8 hours

An adult burn patient is receiving Lactated Ringers fluid resuscitation. Using the Parkland Formula the initial volume of fluid to be administered in the first 24 hours is 30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours, what rate should the nurse infuse the IV fluids? ________________ mL/hr

938 mL/hr Half of the fluid replacement using the Parkland formula is administered in the first 8 hours and the other half over the next 16 hours. In this case, the patient should receive half of the initial rate, or 938 mL/hr.

An adult patient came in to the ED suffering massive burns. Using the rule of nines, what is the estimate extent of burn injury to the following patient. The following areas are burned: Anterior trunk, anterior left arm, and posterior left leg. A. 31.5% B. 36% C. 28.5% D. 30%

A 31.5% Anterior trunk: 18% (means the entire front chest and abdominal area) Anterior left arm: 4.5% Posterior left leg: 9%

A adult patient weighing 80 kg is brought to the emergency department with the following burn injuries: a blistered and reddened anterior trunk, reddened lower back, and pale, waxy anterior right arm. A: Using the Rule of Nine calculate the client's TBSA B Using the Parkland Formula calculate the fluid to be infused in the first 8 hours after arrival. ________________ mL

A: 22.5% B: 3,600 mL in the first 8 hours RATIONALE TBSA: 22.5 %: The anterior trunk has superficial partial-thickness burns and is calculated in TBSA as 18%. The arm has a deep partial-thickness burn and is calculated as 4.5%. The burn on the lower back is superficial and is not calculated in TBSA. 4mL x 22.5% x 80 kg= Total in 24 hours: 7,200 mL 7,200/2= 3,600 mL, which is 50% in the first 8 hours

Which client is most at risk for compartment syndrome due to a burn? A. A 25 yr old with circumferential burn of the anterior and posterior left arm. B. A 7 yr old with a burn of the left and right ear. C. A 54 yr old with an electrical burn on the neck. D. A 16 yr old with a chemical burn to the right foot.

A: Circumferential burns of the extremities are more likely to cause compartment syndrome, because they produce a tourniquet-like effect, which can lead to vascular problems.

A 47 year old male client weighing 91 kg comes in to the ED with burns on his entire head, upper anterior torso, anterior right and left arms and genitalia. The total body surface area is calculated according to the rule of nines and represents the total amount of the person's body that has sustained burns. A: What would be this client's TBSA? ______________% B: Using the Parkland Formula method calculate the mL/hr in the first 8 hours of the client's arrival: ____________ mL/hr

A: TBSA 28% B: 637 mL/hr entire head: 9% upper anterior torso: 9% anterior right and left arms: 9% genitalia: 1%

Calculate the total fluid to be infused in the first 8 hours after arrival for an adult burn victim weighing 81 kg with a TBSA of 19%: A: 2,798 mL B: 3,078 mL C: 12,312 mL D: 6,156 mL

B: 3078 mL 4mL x 19% x 81 kg= 3078 mL

For a burn victim in the first 24 hours of emergent care, which type of fluid would the doctor most likely order as part of fluid resuscitation following a burn injury? A: D5 ½ NS with KCl B: 0.9% Normal saline C: D10W D Lactated Ringer's solution

D Lactated Ringer's solution The usual substance that will be given via IV fluid is Lactated Ringer's Solution. Lactated Ringer's will cause the pH to increase, because people who have sustained burns are usually in a metabolic acidotic state. Therefore, lactated Ringer's help to increase and neutralize the pH.