A 1-month old infant is admitted to the emergency room with severe diarrhea. Which of the following assessments suggests the infant is severely dehydrated?
High specific gravity of urine, moist mucous membranes
Low specific gravity of urine, skin color pale
Fontanelles depressed: capillary refill greater than 4 seconds
Skin moist and flushed, mucous membranes moist
The Correct Answer is C
A. A high specific gravity of urine typically indicates concentrated urine, which can occur in dehydration; however, moist mucous membranes suggest adequate hydration. This combination does not indicate severe dehydration.
B. A low specific gravity of urine usually indicates dilute urine, which is not typical in dehydration; it suggests the kidneys are not concentrating urine due to good fluid intake or other factors. While pale skin can indicate poor perfusion, this option does not specifically indicate severe dehydration.
C. A depressed fontanelle (soft spot on the head) and a capillary refill time greater than 4 seconds are significant indicators of severe dehydration in infants. Depressed fontanelles suggest that the infant is not receiving enough fluids, and prolonged capillary refill time indicates poor perfusion and dehydration.
D. Moist skin and mucous membranes indicate adequate hydration. Flushed skin may occur with certain conditions but does not suggest severe dehydration. This option reflects a well-hydrated status rather than dehydration.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While emotional stress can impact overall health and potentially weaken the immune system, it is not directly related to the transmission or risk factors for salmonellosis. This information is less relevant in identifying the cause of the gastrointestinal symptoms.
B. Smoking can affect general health and immune function, but it is not specifically related to salmonellosis. While it may be a contributing factor to the client's overall health status, it doesn’t provide direct insights into potential sources of infection or recent exposures.
C. Salmonellosis is often linked to foodborne sources, particularly undercooked or contaminated foods. Knowing what the client has eaten can help identify potential sources of the infection and assist in managing the condition effectively. It can also guide public health reporting if a particular food source is identified as a risk.
D. A history of colon cancer could affect the client’s gastrointestinal health, but it is not directly relevant to the diagnosis of salmonellosis. While it may be useful to know for the overall health context, it does not help in identifying the source or confirming the diagnosis of salmonellosis.
Correct Answer is D
Explanation
A. This option includes nausea, which may occur but is not a primary indication for surgery. Belching can happen with digestive issues but does not specifically relate to GERD or the need for Nissen Fundoplication. Weight gain is not directly associated with GERD symptoms and may occur post-surgery due to changes in diet or activity levels.
B. Esophageal reflux is a central symptom of GERD and a primary reason for considering Nissen Fundoplication. While flatulence can occur with various gastrointestinal issues, it is not a hallmark symptom of GERD. Chronic cough may result from acid reflux irritating the throat, but this option does not emphasize the most common and significant symptoms related to the surgery.
C. Epigastric pain may occur in GERD but is not a defining symptom prompting surgery. Hoarseness can result from acid reflux affecting the vocal cords, yet it is not a primary reason for Nissen Fundoplication. Diarrhea is not typically associated with GERD and does not connect to the reasons for the procedure.
D. Heartburn is the classic symptom that drives many patients to seek surgical intervention. Gastroesophageal reflux directly indicates the condition being treated, and chest pain can be a significant discomfort caused by acid reflux.
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