An adult whose both lower limbs are burnt along with genitalia has ______ % hours.

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

The 'Rule of Nines' is a standardized method used to quickly estimate the total body surface area (TBSA) affected by a burn in adults.
According to this rule, each lower limb (leg) accounts for 18% of the TBSA.
The genitalia or perineum area is assigned 1% of the TBSA.
Therefore, the total percentage for burns on both lower limbs is 18% + 18% = 36%.
Adding the 1% for the genitalia brings the total calculated TBSA to 36% + 1% = 37%.

Option A: This percentage (18%) only accounts for a burn on a single lower limb, not both.
Option B: This percentage (19%) incorrectly calculates the TBSA. It seems to account for only one lower limb (18%) plus the genitalia (1%).
Option C: This percentage (36%) correctly accounts for both lower limbs (18% + 18%) but omits the additional 1% for the genitalia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Calculation of Total Body Surface Area (TBSA) using the Rule of Nines for burns in adults as background academic context rather than a clinical decision trigger.
Accurate TBSA calculation is a critical first step in burn management, as it directly influences the volume of intravenous fluids needed for resuscitation.
The Parkland formula (4 mL x body weight in kg x %TBSA) is commonly used to calculate fluid requirements for the first 24 hours post-burn. An incorrect TBSA estimate can lead to under- or over-resuscitation, both of which have serious complications.
A burn of 37% TBSA is considered a major burn, requiring immediate and aggressive fluid resuscitation to prevent burn shock (a type of hypovolemic shock) and organ failure.

How to Approach the Question

First, identify that the question is asking for a calculation of the total body surface area (TBSA) of a burn.
Recognize that the patient is an adult, which indicates that the 'Rule of Nines' is the appropriate method to use.
Recall the specific percentages assigned to each body part under the Rule of Nines.
Break down the burn areas mentioned in the question: 'both lower limbs' and 'genitalia'.
Assign the correct percentage to each part: 18% for each lower limb and 1% for the genitalia.
Sum the percentages: 18% (limb 1) + 18% (limb 2) + 1% (genitalia) = 37%.

Concept Tested & Keywords

Concept Tested: Calculation of Total Body Surface Area (TBSA) using the Rule of Nines for burns in adults.
Stem keywords: adult, both lower limbs, burnt, genitalia
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 693-695

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