You are assuming care for a 34-year-old female patient who has sustained second- and third-degree burns over her anterior chest and abdomen, and entire left arm

You are assuming care for a 34-year-old female patient who has sustained second- and third-degree burns over her anterior chest and abdomen, and entire left arm. The burn injury occurred in her home at 0600; her spouse did not survive the fire, but due to the patient’s critical condition, she is not aware of his death. It is now 0800.  She has been admitted to the surgical intensive care unit. Her vital signs are 36.6-126-12; 104/60, SpO2=90%.  She is sedated with a continuous infusion of Propofol, and is intubated and on a mechanical ventilator. She has a right femoral triple lumen catheter, and a right radial arterial line. The patient weighs 60 kilograms.

1. Using the rule of nines, calculate the patient’s total body surface area burned.  Use a Rule of Nines diagram.

2. Based on your calculation of % body surface area burned, and using the  maximum rate in the Consensus Formula—4mL/kg/%TBSA–, how much fluid resuscitation should the patient receive in the first 8 hours…assuming her IV access has just now been obtained? What will her hourly rate be in the first 8 hours?  What will the rate be in the next 16 hours?… And what would her hourly urine output minimums be?

a. Total amount of fluid to be given in the first 8 hours and hourly rate:

b.  IV rate for next 16 hours:

c. Hourly urine output minimums:

3. What are the biggest threat(s) to this patient in the next 24 hours?  Look at the complications listed in the book and on the PowerPoint for the first 24 hours.