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The nurse is caring for a client who weighs 182 lb and sustained burns over 55% of the total body surface area (TBSA). It requires follow-up with the primary health care provider (PHCP) if the client's urine output is noted to be:

A. 0.6 mL/kg/hr
B. 500 mL over 24 hours
C. 300 mL over 8 hours
D. 1 mL/kg/hr

Answer :

A client with a weight of 182 lb and burns over 55% TBSA requires follow-up if urine output is B. 500 mL over 24 hours.

Let's evaluate each option with respect to the patient's weight and recommended urine output for adequate renal function.

Weight Conversion

The client's weight is 182 lb. To convert pounds to kilograms:

Weight in kg = 182 / 2.2

≈ 82.7 kg

Urine Output Analysis

Medical guidelines suggest minimum urine output should be around 0.5 mL/kg/hr to prevent oliguria (insufficient urine production):

  • A) 0.6 mL/kg/hr: This calculates to 0.6 * 82.7 kg ≈ 49.6 mL/hr. Over a 24-hour period, it totals approximately 1190 mL/day, which is adequate.
  • B) 500 mL over 24 hours: This results in about 20.8 mL/hr (500 / 24), which is significantly lower than needed to prevent oliguria.
  • C) 300 mL over 8 hours: This results in 37.5 mL/hr (300 / 8), still marginally acceptable but lower than desired.
  • D) 1 mL/kg/hr: This comes to 1 * 82.7 kg = 82.7 mL/hr, amounting to approximately 1985 mL/day, which is more than sufficient.

Given these evaluations, option B indicates oliguria and would require follow-up with the primary health care provider.

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