Related Questions

Correct Answer is B

Explanation

Choice A Reason: This is incorrect because monitoring the client's electrolyte levels is not the highest priority, as it does not address the immediate risk of airway obstruction or aspiration.

Choice B Reason: This is correct because suctioning saliva from the client's mouth is the highest priority, as it prevents airway obstruction and aspiration, which can lead to respiratory distress and infection.

Choice C Reason: This is incorrect because recording the client's intake and output is not the highest priority, as it does not address the immediate risk of airway obstruction or aspiration.

Choice D Reason: This is incorrect because performing passive range of motion on each extremity is not the highest priority, as it does not address the immediate risk of airway obstruction or aspiration.

Correct Answer is ["100"]

Explanation

To estimate the percentage of body surface area burned using the Rule of Nines, follow these guidelines:

  1. Head and Neck: 9%
  2. Each Arm: 9% (right arm) + 9% (left arm) = 18%
  3. Front of Torso: 18%
  4. Back of Torso: 18%
  5. Each Leg: 18% (right leg) + 18% (left leg) = 36%
  6. Genital Area: 1%

Now, add up the percentages of the burned areas:

9% (head and neck) + 18% (each arm) + 18% (front of torso) + 18% (back of torso) + 36% (each leg) + 1% (genital area) = 100%

So, the nurse should estimate that the client has burned 100% of their body surface area.

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