N158 nursing care of infants proctored exam (paediatrics)
Calculation
A 12-year-old (40 kg) presents to the emergency department after a fireworks explosion during a neighborhood celebration. The child has: Deep partial-thickness burns on the posterior surface of the right thigh Full-thickness burns on the posterior trunk Superficial partial-thickness burns on the left forearm and hand (anterior surface only) Using the modified Lund-Browder chart for a 12-year-old, calculate the Total Body Surface Area (TBSA) burned. Round your answer to the nearest tenth if applicable and enter digits only. Modified Lund-Browder chart for assessing percentage total body surface area burn in children and adults Area Birth to 1 year 1 to 4 years 5 to 9 years 10 to 14 years Adult Head 9.5 8.5 6.5 5.5 4.5 Neck 1 1 1 1 1 Trunk 13 13 13 13 13 Upper arm 2 2 2 2 2 Forearm 1.5 1.5 1.5 1.5 1.5 Hand 1.25 1.25 1.25 1.25 1.25 Thigh 2.75 3.25 4 4.25 4.5 Leg 2.5 2.5 2.5 3 3.25 Foot 1.75 1.75 1.75 1.75 1.75 Buttock 2.5 2.5 2.5 2.5 2.5 Genitalia 1 1 1 1 1 Values listed are for one surface area and each individual extremity. Anterior and posterior surface area values are equivalent in estimating total body surface area (TBSA). For circumferential burns, multiply surface area burned by two.
%
Explanation & Rationale
Identify the body surface area values for a 12-year-old (10 to 14 years). Thigh 4.25% Trunk 13% Forearm 1.5% Hand 1.25% Calculate the TBSA for each burned area. The anterior and posterior surfaces of an area are considered equivalent (half of the total area value). Posterior Right Thigh 2.125% Posterior Trunk 6.5% Anterior Left Forearm 0.75% Anterior Left Hand 0.625% Calculate the Total Body Surface Area (TBSA) burned. Total TBSA = Sum of all affected areas = 2.125 + 6.5 + 0.75 + 0.625$ = 10.0 %
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