Deck 40: The Child With a Fluid and Electrolyte Alteration

Question 1

The nurse who provides care for young children with fluid and electrolyte imbalance understands that they are more vulnerable to changes in fluid balance than adults.Under normal conditions the amount of fluid ingested during the day should equal the amount of fluid lost.Sensible water loss is that which occurs through the respiratory tract and skin.Is this statement true or false?

Answer 1

False

Question 2

Which action is the primary concern in the treatment plan for a child with persistent vomiting?

A) Detecting the cause of vomiting
B) Preventing metabolic acidosis
C) Positioning the child to prevent further vomiting
D) Recording intake and output

Answer 2

Detecting the cause of vomiting

Question 3

Which assessment findings indicate to the nurse that a child has excess fluid volume? Select all that apply.

A) Weight gain
B) Decreased blood pressure
C) Moist breath sounds
D) Poor skin turgor
E) Rapid bounding pulse

Answer 3

Weight gain
Moist breath sounds
Rapid bounding pulse

Question 4

The parents of a child with acid-base imbalance ask the nurse about mechanisms that regulate acid-base balance.Which statement by the nurse accurately explains the mechanisms regulating acid-base balance in children?

A) The respiratory, renal, and chemical-buffering systems
B) The kidneys balance acid; the lungs balance base
C) The cardiovascular and integumentary systems
D) The skin, kidney, and endocrine systems

Question 5

You are caring for a 44-lb child who is hospitalized with vomiting and severe dehydration.The physician has ordered parenteral rehydration therapy to restore circulation.The order is for sodium chloride (0.9%)solution in a 20 mL/kg bolus.How much will you give?

Question 6

What is the priority nursing intervention for a 6-month-old infant hospitalized with diarrhea and dehydration?

A) Estimating insensible fluid loss
B) Collecting urine for culture and sensitivity
C) Palpating the posterior fontanel
D) Measuring the infant's weight

Question 7

A nurse is teaching parents about diarrhea.Which statement by the parents indicates understanding of the teaching?

A) Diarrhea results from a fluid deficit in the small intestine.
B) Organisms destroy intestinal mucosal cells, resulting in an increased intestinal surface area.
C) Malabsorption results in metabolic alkalosis.
D) Increased motility results in impaired absorption of fluid and nutrients.

Question 8

What is the best response by the nurse to a parent asking about antidiarrheal medication for her 18-month-old child?

A) "It is okay to give antidiarrheal medication to a young child as long as you follow the directions on the box for correct dosage."
B) "Antidiarrheal medication is not recommended for young children because it slows the body's attempt to rid itself of the pathogen."
C) "I'm sure your child won't like the taste, so give extra fluids when you give the medication."
D) "Antidiarrheal medication will lessen the frequency of stools, but give your child Gatorade to maintain electrolyte balance."

Question 9

What assessment should the nurse make before initiating an intravenous (IV)infusion of dextrose 5% in 0.9% normal saline solution with 10 mEq of potassium chloride for a child hospitalized with dehydration?

A) Fluid intake
B) Number of stools
C) Urine output
D) Capillary refill

Question 10

Which diet would the nurse recommend to the mother of a child who is having mild diarrhea?

A) Rice, potatoes, yogurt, cereal, and cooked carrots
B) Bananas, rice, applesauce, and toast
C) Apple juice, hamburger, and salad
D) Whatever the child would like to eat

Question 11

A child has a 2-day history of vomiting and diarrhea.He has hypoactive bowel sounds and an irregular pulse.Electrolyte values are sodium,139 mEq/L; potassium,3.3 mEq/L; and calcium,9.5 mg/dL.This child is likely to have which of the following electrolyte imbalances?

A) Hyponatremia
B) Hypocalcemia
C) Hyperkalemia
D) Hypokalemia

Question 12

What is the best response for the nurse to give a parent about contacting the physician regarding an infant with diarrhea?

A) "Call your pediatrician if the infant has not had a wet diaper for 6 hours."
B) "The pediatrician should be contacted if the infant has two loose stools in an 8-hour period."
C) "Call the doctor immediately if the infant has a temperature greater than 100° F."
D) "Notify the pediatrician if the infant naps more than 2 hours."

Question 13

What is the most important factor in determining the rate of fluid replacement in the dehydrated child?

A) The child's weight
B) The type of dehydration
C) Urine output
D) Serum potassium level

Question 14

Bodily fluids are composed of two elements; water and _____.

Question 15

Alterations in acid-base balance can affect cellular metabolism and enzymatic processes.When alterations in pH become too much for buffer systems to handle,compensatory mechanisms are activated.If the pH drops below normal than acidosis will occur.Is this statement true or false?

Question 16

Which assessment is most relevant to the care of an infant with dehydration?

A) Temperature, heart rate, and blood pressure.
B) Respiratory rate, oxygen saturation, and lung sounds.
C) Heart rate, sensorium, and skin color.
D) Diet tolerance, bowel function, and abdominal girth.

Question 17

Which statement best describes why infants are at greater risk for dehydration than older children?

A) Infants have an increased ability to concentrate urine.
B) Infants have a greater volume of intracellular fluid.
C) Infants have a smaller body surface area.
D) Infants have an increased extracellular fluid volume.