Question 1

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

Accepted Answer

0.9% Normal Saline is the initial fluid of choice for rehydration in severe isotonic dehydration as it replaces both water and salt deficits. D5W, Albumin, and D5 0.2% (1/4) Normal Saline are not isotonic and do not provide the necessary electrolyte replacement.

Question 2

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

Accepted Answer

Fontanels depressed and capillary refill greater than three seconds are both signs of severe dehydration in an infant. Skin moisture/flushing and specific gravity of urine can be affected by factors other than dehydration.

Question 3

The nurse is planning an in-service for new RNs who will be working on a general pediatric unit. Which statements are appropriate to include when discussing normal acid-base balance? Select all that apply.

Accepted Answer

A,C,E

Question 4

The nurse educator is preparing an in-service for new RNs hired on a general pediatric unit regarding normal fluid and electrolyte status for children at various ages. Which statements will the educator include about normal fluid and electrolyte status of an infant? Select all that apply.

Accepted Answer

The answer of The nurse educator is preparing an in-service...

Question 5

The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?

Accepted Answer

Tachycardia (fast heart rate) is a sign of early or mild dehydration in infants. Dry mucous membranes are also indicative of dehydration, but it is not a sign of the stage of dehydration. Increased blood pressure is not a typical sign of dehydration in infants, and decreased blood pressure is a sign of severe dehydration.

Question 6

In the morning, a nurse receives a report on four pediatric clients who have some form of fluid-volume excess. Which client should the nurse assess first?

Accepted Answer

Tachypnea and pulmonary congestion indicate that the client is experiencing acute or severe fluid volume excess, which may be life-threatening. This client should be assessed first to ensure their respiratory status is stable and to prevent further deterioration.

Question 7

The nurse is completing the intake and output record for a preschool-age client admitted for fluid volume deficit. The client has had the following intake and output during the shift: Intake: 4 oz of Pedialyte 1/2 of an 8-oz cup of clear orange Jell-O 2 graham crackers 200 mL of D 5-1/2 sodium chloride IV Output: 345 mL of urine 50 mL of loose stool The nurse documents the client's intake as ________ milliliters. Round the answer to the nearest whole number.

Accepted Answer

The answer of The nurse is completing the intake and...

Question 8

Match between columns
                        Premises: Occurs when fluid loss is characterized by a proportionately greater loss of water than sodium.
Occurs when fluid loss is characterized by a proportionately greater loss of sodium than water.
Occurs when fluid loss is not balanced by intake, and the loss of water and sodium are in proportion.

Accepted Answer

The Answer of Isotonic dehydration and Hypotonic dehydration and Hypertonic is...

Question 9

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a new RN on the pediatric unit, cautions the new nurse to be especially alert for which condition in the child?

Accepted Answer

Hyponatremia can lead to cerebral edema, which can cause seizures in children. The nurse should be especially alert for signs of seizure activity and prepared to administer appropriate medications if needed. Bradycardia, respiratory distress, and hyperthermia are not typically associated with hyponatremia.

Question 10

A school-age client is hypokalemic. The nurse is helping the client complete her menu. Which food selection will the nurse encourage for this client?

Accepted Answer

Pizza with a fruit plate is the best choice for a hypokalemic client as it is high in potassium. The other options are high in sodium and low in potassium, which could worsen the hypokalemia.

Question 11

The school-age child is admitted to the hospital with dehydration. The child weighs 30 pounds. The physician orders: 50 mL/kg 0.9 percent NSS with 5 percent dextrose IV over 4 hours. Calculate the IV pump to infuse 50 mL/kg/4hrs. Supply on hand: 1000 mL 0.9 percent NSS/ 2.5 percent dextrose

Accepted Answer

The answer of The school-age child is admitted to the...

Question 12

A nurse is planning care for a child with hyperkalemia. Which clinical manifestation will the nurse plan to assessment this child for based on the diagnosis?

Accepted Answer

Hyperkalemia can cause bradycardia due to the increased potassium interfering with the electrical conduction in the heart. Seizures, respiratory distress, and hyperthermia are not typically associated with hyperkalemia.

Question 13

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate?

Accepted Answer

A higher-concentrated formula can lead to dehydration because of the high sodium content. Instead, the nurse should discuss other strategies for increasing the infant's weight gain, such as increasing the frequency of feedings or adding additional nutrients through breast milk or supplements.

Question 14

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?

Accepted Answer

Furosemide (Lasix) is a loop diuretic that is used for the treatment of hypercalcemia by promoting the excretion of calcium in the urine. It acts on the thick ascending limb of the loop of Henle to inhibit the reabsorption of sodium, chloride, and calcium. Hydrochlorothiazide (Aquazide) is a thiazide diuretic that promotes sodium and water excretion, but it is not effective for calcium excretion. Spironolactone (Aldactone) is a potassium-sparing diuretic that is not effective for calcium excretion. Mannitol (Osmitrol) is an osmotic diuretic that increases urine output by raising the osmotic pressure in the renal tubules, but it is not effective for calcium excretion.

Question 15

A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7 percent of the normal body weight. The nurse is double-checking the IV rate the practitioner has ordered. The formula the practitioner used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 cc for every kg over 10 for 24 hours. Replacement fluid is the percentage of lost body weight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, this child's hourly IV rate for 24 hours should be ________ mL.
Round the answer to the nearest whole number.

Accepted Answer

The answer of A child is being treated for dehydration...

Question 16

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which is the priority diagnosis for this child?

Accepted Answer

The priority diagnosis for this child is Risk for Impaired Skin Integrity as severe edema in a lower leg can cause skin breakdown, leading to potential infection and further complications. The other diagnoses are important to monitor and address but are not as immediately urgent as preventing skin breakdown.

Question 17

A preschool-aged client, diagnosed with croup, has an increased pCO₂, a decreased pH, and a normal HCO₃ blood-gas value. Which documentation in the medical record is the most appropriate?

Accepted Answer

Increased pCO₂ (partial pressure of carbon dioxide) and decreased pH indicate acidosis. Normal HCO₃ (bicarbonate) suggests that compensation has not yet occurred. Since the client has croup, which is a respiratory condition, the acidosis is likely due to impaired gas exchange in the lungs, resulting in retained carbon dioxide. Therefore, the most appropriate documentation is uncompensated respiratory acidosis.

Question 18

The nurse finishes a parent-teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?

Accepted Answer

The statement "During activity, stop for fluids every 15 to 20 minutes" indicates that the parent understands the importance of frequent hydration during exercise. This helps prevent heat-related illnesses. A is incorrect because hydration should occur during exercise, not just at the end. B is correct, but not as specific as D. C is incorrect because dark clothing can increase the risk of heat-related illnesses by absorbing more heat from the sun.

Question 19

A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration?

Accepted Answer

The answer of A nurse is taking care of four...

Quiz 18: Alterations in Fluid, Electrolyte, and Acid-Base Balance

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

The nurse is planning an in-service for new RNs who will be working on a general pediatric unit. Which statements are appropriate to include when discussing normal acid-base balance? Select all that apply.

The nurse educator is preparing an in-service for new RNs hired on a general pediatric unit regarding normal fluid and electrolyte status for children at various ages. Which statements will the educator include about normal fluid and electrolyte status of an infant? Select all that apply.

The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?

In the morning, a nurse receives a report on four pediatric clients who have some form of fluid-volume excess. Which client should the nurse assess first?

Match the description with types of dehydration .

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a new RN on the pediatric unit, cautions the new nurse to be especially alert for which condition in the child?

A school-age client is hypokalemic. The nurse is helping the client complete her menu. Which food selection will the nurse encourage for this client?

The school-age child is admitted to the hospital with dehydration. The child weighs 30 pounds. The physician orders: 50 mL/kg 0.9 percent NSS with 5 percent dextrose IV over 4 hours. Calculate the IV pump to infuse 50 mL/kg/4hrs. Supply on hand: 1000 mL 0.9 percent NSS/ 2.5 percent dextrose

A nurse is planning care for a child with hyperkalemia. Which clinical manifestation will the nurse plan to assessment this child for based on the diagnosis?

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate?

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which is the priority diagnosis for this child?

A preschool-aged client, diagnosed with croup, has an increased pCO₂, a decreased pH, and a normal HCO₃ blood-gas value. Which documentation in the medical record is the most appropriate?

The nurse finishes a parent-teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?

A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration?

Quiz 18: Alterations in Fluid, Electrolyte, and Acid-Base Balance

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

The nurse is planning an in-service for new RNs who will be working on a general pediatric unit. Which statements are appropriate to include when discussing normal acid-base balance? Select all that apply.

The nurse educator is preparing an in-service for new RNs hired on a general pediatric unit regarding normal fluid and electrolyte status for children at various ages. Which statements will the educator include about normal fluid and electrolyte status of an infant? Select all that apply.

The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?

In the morning, a nurse receives a report on four pediatric clients who have some form of fluid-volume excess. Which client should the nurse assess first?

Match the description with types of dehydration .

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a new RN on the pediatric unit, cautions the new nurse to be especially alert for which condition in the child?

A school-age client is hypokalemic. The nurse is helping the client complete her menu. Which food selection will the nurse encourage for this client?

The school-age child is admitted to the hospital with dehydration. The child weighs 30 pounds. The physician orders: 50 mL/kg 0.9 percent NSS with 5 percent dextrose IV over 4 hours. Calculate the IV pump to infuse 50 mL/kg/4hrs. Supply on hand: 1000 mL 0.9 percent NSS/ 2.5 percent dextrose

A nurse is planning care for a child with hyperkalemia. Which clinical manifestation will the nurse plan to assessment this child for based on the diagnosis?

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate?

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which is the priority diagnosis for this child?

A preschool-aged client, diagnosed with croup, has an increased pCO2, a decreased pH, and a normal HCO3 blood-gas value. Which documentation in the medical record is the most appropriate?

The nurse finishes a parent-teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?

A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration?

A preschool-aged client, diagnosed with croup, has an increased pCO₂, a decreased pH, and a normal HCO₃ blood-gas value. Which documentation in the medical record is the most appropriate?