Rule of 9's and the Parkland Formula Burns practice questions

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%

A 30 year old female patient has deep partial thickness burns on the back of the right arm, posterior trunk, front of the left leg, anterior head and neck, and perineum. The patient weighs 150 lbs. Use the Parkland Burn Formula to calculate the total amount of Lactated Ringers that will be given over the next 24 hours?*

10,064 ML Formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. Pt's weight 150 lbs....convert to kg....150 divided by 2.2 = 68 kg. BSA percentage: 37%...Back of right arm (4.5%), posterior trunk (18%), front of left leg (9%), anterior head and neck (4.5%) and perineum (1%) which equals 37%......4 x 37 x 68 = 10,064 mL

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

A 45 year old female patient has superficial partial thickness burns on the posterior head and neck, front of the left arm, front and back of the right arm, posterior trunk, front and back of the left leg, and back of right leg. The patient weighs 91 kg. Use the Parkland Burn Formula to calculate the total amount of Lactated Ringers that will be given over the next 24 hours?

22,932 ML Formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. Pt's weight 91 kg. BSA percentage: 63%... posterior head and neck (4.5%), front of the left arm (4.5%), front and back of the right arm (9%), posterior trunk (18%), front and back of the left leg (18%), back of right leg (9%) equals: 63%......4 x 63 x 91 = 22,932 mL

A 30 year old female patient has deep partial thickness burns on the front and back of the right and left leg, front of right arm, and anterior trunk. The patient weighs 63 kg. Use the Parkland Burn Formula: What is the flow rate during the FIRST 8 hours (mL/hr) based on the total you calculated?*

921ml/hr First calculate the total amount of fluid needed with the formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. The pt's weight 63 kg. BSA percentage: 58.5%...Front and back of right and left leg (36%), front of right arm (4.5%), anterior trunk (18%) which equals 58.5%. ......4 x 58.5 x 63 = 14,742 mL......Remember during the FIRST 8 hours 1/2 of the solution is infused, which will be 14,742 divided by 2 = 7371 mL......Hourly Rate: 7371 divide by 8 equals 921 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%

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

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.

Burns Priority Plan (BURNS, PROTECT, PPPPPP)

B-breathing, keeping airway open (intubating early is good) U-Urine output (0.5mL/kg/hr)=37.5 mL/hr(min.) R- Rule of 9's N- nutrition - Protein min 4-6,000 calories/day S- Burn Shock (hypovolemic shock) P- Private Room R- requires ALL PPE (including family in PPE) O- Orient Client Transport T- Things in room (No fresh flowers, fruits, vegetables,) E- Eliminate sharing of anything C- Closely monitor any signs of infection T- Teaching about clients/visitors family standard precautions etc. P-Positive P-pressure P-positively P- Prevents P- Patient infection by P- Pushing air out Everything needs to be sterile. Wounds: sterile technique. Preventing infection is key

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

A 29 year old male patient has superficial partial thickness burns on the anterior right arm, posterior left leg, and anterior head and neck. The patient weighs 78 kg. Use the Parkland Burn Formula to calculate the total amount of Lactated Ringers that will be given over the next 24 hours?*

B: 5,616 mL. Formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. Pt's weight 78 kg. BSA percentage: 18%...Anterior right arm (4.5%), posterior left leg (9%), and anterior head and neck (4.5%) which equals 18%.....4 x 18 x 78 = 5,616 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.

4. A 59 year old male patient has full thickness burns on both of the legs on the back, front and back of the trunk, both arms on the front and back, and front and back of the head and neck. The patient weighs 186 lbs. Use the Parkland Burn Formula: You've already infused fluids during the first 8 hours. Now what will you set the flow rate during the next 16 hours (mL/hr) based on the total you calculated?

D: 861 mL/hr First calculate the total amount of fluid needed with the formula: Total Amount of LR = 4 mL x BSA % x pt's weight in kg. The pt's weight 186 lbs...need to convert to kg: 186 divided by 2.2 = 85 kg. BSA percentage: 81%...Both of the legs on the back (18%), front and back of the trunk (36%), both arms on the front and back (18%), front and back of the head and neck (9%) which equals 81%.......4 x 81 x 85 = 27,540 mL. You've already infused half of the solution during the first 8 hours...so 13,770 mL is left and it needs to be infused over 16 hours. Hourly rate: 13,770 mL divided by 16 hours equals 861 mL/hr

A 58 year old female patient has superficial partial-thickness burns to the anterior head and neck, front and back of the left arm, front of the right arm, posterior trunk, front and back of the right leg, and back of the left leg. Using the Rule of Nines, calculate the total body surface area percentage that is burned? A. 63% B. 81% C. 72% D. 54%

The answer is A. Anterior head and neck (4.5%), front and back of the left arm (9%), front of the right arm (4.5%), posterior trunk (18%), front and back of the right leg (18%), back of the left leg (9%) which equals 63%.

A 25 year old female patient has sustained burns to the back of the right arm, posterior trunk, front of the left leg, anterior head and neck, and perineum. Using the Rule of Nines, calculate the total body surface area percentage that is burned? A. 46% B. 37% C. 36% D. 28%

The answer is B. Back of right arm (4.5%), posterior trunk (18%), front of left leg (9%), anterior head and neck (4.5%) and perineum (1%) which equals 37%.

A 35 year old male patient has superficial partial-thickness burns to the anterior right arm, posterior left leg, and anterior head and neck. Using the Rule of Nines, calculate the total body surface area percentage that is burned? A. 36% B. 9% C. 18% D. 29%

The answer is C. Anterior right arm (4.5%), posterior left leg (9%), and anterior head and neck (4.5%) which equals 18%.

A 66 year old female patient has deep partial-thickness burns to both of the legs on the back, front and back of trunk, both arms on the front and back, and front and back of the head and neck. Using the rule of nines, calculate the total body surface area percentage that is burned? A. 72% B. 63% C. 81% D. 45%

The answer is C. Both of the legs on the back (18%), front and back of the trunk (36%), both arms on the front and back (18%), front and back of the head and neck (9%) which equals 81%.

A 68 year old male patient has partial thickness burns to the front and back of the right and left leg, front of arm, and anterior trunk. Using the rule of Nines, calculate the total body surface area percentage that is burned? A. 40.5% B 49.5% C. 58.5% D. 67.5%

The answer is C. Front and back of right and left leg (36%), front of right arm (4.5%), anterior trunk (18%) which equals 58.5%.

A 35 year old male patient has full thickness burns to the anterior and posterior head and neck, front of left leg, and perineum. Using the Rule of Nines, calculate the total body surface area percentage that is burned? A. 37% B. 14.5% C. 29% D. 19%

The answer is D. Anterior and posterior head and neck (9%), front of left leg (9%), perineum (1%) which equals 19%.