A nurse in an emergency department is caring for a client who has burns on the front and back of both his legs and arms. Using the rule of nines, the nurse should document burns to which percentage of the client's total body surface area (TBSA)?

Step 1 is: Calculate the percentage for the front of both legs and arms. Front of both legs is 9% + 9% = 18%. Front of both arms is 4.5% + 4.5% = 9%. Total is 18% + 9% = 27%. Step 2 is: Calculate the percentage for the back of both legs and arms. Back of both legs is 9% + 9% = 18%. Back of both arms is 4.5% + 4.5% = 9%. Total is 18% + 9% = 27%. Step 3 is: Add the percentages from steps 1 and 2 to find the total body surface area burned. 27% + 27% = 54%. The client's total body surface area burned is 54 percent. *.