Question 1

You would expect to see hypokalemia in which of the following conditions?

Accepted Answer

Loss of gastric or intestinal fluids can lead to hypokalemia because potassium is lost along with the fluids. Conditions such as vomiting or diarrhea can cause significant potassium loss.

Question 2

In which of the following ways does the concentration of hydrogen ions affect the movement of potassium ions into or out of cells, if at all?

Accepted Answer

The answer of In which of the following ways does...

Question 3

The nurse assesses a child and finds the child to have hypotonic muscles, decreased respirations, and to be irritable. Looking at the lab work, the nurse will likely find:

Accepted Answer

The symptoms of hypotonic muscles, decreased respirations, and irritability can be associated with electrolyte imbalances, specifically hyponatremia (low sodium) and hypochloremia (low chloride), which can affect muscle function and neurological status.

Question 4

Acid-base metabolism of the body is controlled by the:

Accepted Answer

The respiratory system plays a crucial role in acid-base balance by retaining or releasing carbon dioxide (CO2), which influences the pH of blood and body fluids. CO2 combines with water to form carbonic acid, which dissociates into hydrogen ions and bicarbonate, affecting the acid-base balance.

Question 5

When there are pH changes caused by respiratory problems or a buildup of metabolic acids, compensation will take place by what method?

Accepted Answer

The kidneys play a crucial role in compensating for pH changes in the body by controlling the levels of hydrogen ions and bicarbonate in the blood. This helps to correct imbalances caused by respiratory problems or the buildup of metabolic acids.

Question 6

The nurse is working with a child who has a drug overdose. Respirations are decreased and shallow. Arterial blood gases show the child's pH is decreased and the pCO₂ is elevated. The nurse realizes that this child is in:

Accepted Answer

The child's symptoms of decreased and shallow respirations, along with decreased pH and elevated pCO2, indicate respiratory acidosis. This condition occurs when the lungs cannot remove enough carbon dioxide, leading to an acidic state.

Question 7

The nurse is assigned to an adolescent who is admitted with out-of-control diabetes. There are high levels of ketones in the urine. The child has Kussmaul's respirations and is confused and somewhat lethargic. The nurse knows that this child is in:

Accepted Answer

The child is exhibiting signs of diabetic ketoacidosis (DKA), a condition characterized by high levels of ketones in the urine, Kussmaul's respirations (deep, rapid breathing), confusion, and lethargy. These symptoms indicate metabolic acidosis, where the body produces excess acid (ketones) or the kidneys are not removing enough acid from the body.

Question 8

A child is more susceptible to dehydration states than adults because children:

Accepted Answer

Children have a larger proportion of their total body fluid in extracellular spaces, making them more susceptible to fluid loss and dehydration.

Question 9

One type of dehydration in children is isotonic dehydration, which occurs then:

Accepted Answer

Isotonic dehydration occurs when the loss of sodium and water from the body is proportional, leading to a situation where the serum sodium level remains within the normal range. This type of dehydration does not alter the balance between intracellular and extracellular sodium concentrations significantly.

Question 10

The nurse is working with a child who has a diagnosis of gastroenteritis. The child becomes dehydrated, has serum sodium of 125 milliequivalents per liter, and goes into shock. After corrective measures to restore the child's electrolyte balance and hydration status, the nurse realizes that this child had which of the following types of dehydration?

Accepted Answer

Hypotonic dehydration occurs when the sodium loss exceeds the water loss, leading to a serum sodium level lower than normal (<135 milliequivalents per liter), as indicated by the child's serum sodium of 125 milliequivalents per liter.

Question 11

Hypertonic dehydration occurs in which of the following conditions?

Accepted Answer

Hypertonic dehydration occurs when the vascular space loses more fluid than particles, leading to a higher concentration of solutes (particles) in the blood. This can happen in situations where water loss exceeds electrolyte loss, such as in cases of excessive sweating, fever, or diabetes insipidus.

Question 12

Which of the following methods is the most reliable method of diagnosing dehydration in children?

Accepted Answer

Weight loss is the most reliable method for diagnosing dehydration in children. It provides a direct measure of fluid loss, unlike other indicators which can be influenced by various factors and may not accurately reflect the hydration status.

Question 13

Classical symptoms of impending shock in a child who is dehydrated are:

Accepted Answer

The answer of Classical symptoms of impending shock in a...

Question 14

The nurse is working with a child who is dehydrated. When the nurse weighs the child and compares the weight obtained with the child's weight prior to the illness, there has been an 8% weight loss. This weight loss means that this child's dehydration is:

Accepted Answer

An 8% weight loss in a child due to dehydration is classified as moderate dehydration. Mild dehydration is typically a 3-5% weight loss, moderate is 6-9%, and severe is 10% or more.

Question 15

Children with an internal hemorrhage such as bleeding into the thoracic or peritoneal cavity will have the same signs and symptoms of hypovolemic shock as a child with an external hemorrhage, except for one difference, which is:

Accepted Answer

In external hemorrhage, blood loss is visible and can lead to weight loss, whereas in internal hemorrhage, the blood is retained within the body cavities, so there is no immediate weight loss.

Question 16

The nurse is working as a volunteer on a health care team serving in a clinic in a village in a third world country. Several children come to the clinic in a mild or moderate state of dehydration. Which of the following solutions or liquids would be best for rehydrating the dehydrated children?

Accepted Answer

Pedialyte is specifically formulated to replace fluids and minerals (electrolytes) lost during diarrhea and vomiting. It is designed to prevent or treat dehydration in children, making it the best choice among the options provided.

Question 17

The nurse will read the label to determine the contents of any solution before using it for rehydration because solutions must contain which of the following substances in order for the intestines to absorb sodium chloride?

Accepted Answer

Glucose is necessary for the co-transport mechanism in the intestines that facilitates the absorption of sodium chloride. This process is essential for effective rehydration, as it helps in the retention of fluids within the body.

Question 18

The nurse is assessing a 5-year-old child. In checking the heart rate, the nurse finds an increase of 25 beats then the child changes from a lying to a standing position. This increase in heart rate is indicative of:

Accepted Answer

An increase in heart rate when changing from a lying to a standing position can indicate hypovolemia. This is because the body compensates for the decreased venous return and lower blood volume by increasing the heart rate to maintain adequate blood pressure and perfusion.

Question 19

The nurse is assessing a child who is dehydrated. The child begins to cry, but there are no tears. The nurse knows that the loss of the ability to produce tears indicates a fluid loss of at least what percent of the child's body weight?

Accepted Answer

The inability to produce tears in a dehydrated child typically indicates a fluid loss of at least 5% of the child's body weight.

Question 20

The nurse is preparing to administer intravenous fluids containing potassium for a child who is dehydrated. Which of the following is the most important thing for the nurse to check before administering the potassium?

Accepted Answer

Before administering potassium, it's crucial to ensure the child's kidneys are functioning properly to avoid the risk of hyperkalemia. The ability to void at least 1 to 2 milliliters per kilogram per hour indicates adequate kidney function.

Quiz 21: Fluid and Electrolyte Alterations