A child weighs 32.7 kg and requires maintenance IV fluids.
What infusion rate in milliliters per hour (mL/hr) should the nurse set on the IV pump to meet the child's 24-hour fluid requirement? Round your answer to the nearest tenth and enter only digits (not units). —
The Correct Answer is ["73.1"]
Step 1 is: Calculate the total daily fluid requirement using the Holliday-Segar formula. The child weighs 32.7 kg. For the first 10 kg: 10 kg× 100 mL/kg = 1000 mL. For the next 10 kg (from 10.1 kg to 20 kg): 10 kg× 50 mL/kg = 500 mL. For the remaining weight: 32.7 kg - 20 kg = 12.7 kg. Remaining weight fluid: 12.7 kg× 20 mL/kg = 254 mL. Total daily fluid requirement: 1000 mL + 500 mL + 254 mL = 1754 mL.
Step 2 is: Calculate the infusion rate in milliliters per hour (mL/hr). Rate = Total fluid÷Total hours. Rate = 1754 mL÷ 24 hr = 73.0833… mL/hr.
Step 3 is: Round the answer to the nearest tenth. 73.1 mL/hr. The infusion rate is 73.1 mL/hr.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
An oxygen saturation of 88.
Choice B rationale
Bounding peripheral pulses are a classic finding in Patent Ductus Arteriosus (PDA) due to the wide pulse pressure, which results from the run-off of blood from the aorta back into the pulmonary artery during diastole. This finding supports the diagnosis but is not typically the most concerning indicator of impending decompensation.
Choice C rationale
The machinery-like murmur is the pathognomonic sign of a Patent Ductus Arteriosus, caused by continuous blood flow from the high-pressure aorta to the low-pressure pulmonary artery. This is an expected diagnostic finding for PDA, confirming the presence of the defect, but it is not an indicator of acute distress.
Choice D rationale
A respiratory rate of 60 breaths per minute in a 2-month-old infant is a significant indicator of tachypnea and potential respiratory distress, likely due to pulmonary overcirculation and the resulting congestive heart failure (CHF) caused by the PDA. This elevated rate signals a critical effort to compensate for decreased pulmonary compliance and is the most immediate concern.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Hypercyanotic spells, or "tet spells," result from a sudden decrease in pulmonary blood flow and increased right-to-left shunting, leading to profound hypoxemia. Administering oxygen helps by slightly increasing arterial oxygen tension, which acts as a mild pulmonary vasodilator, potentially reducing pulmonary vascular resistance and improving oxygen delivery to tissues. This aims to counteract the immediate hypoxemia.
Choice C rationale
Morphine administration is appropriate because of its central nervous system depressant effects. It helps to calm the infant, decreasing systemic oxygen demands and reducing the hyperpnea (rapid, deep breathing) that often accompanies the spell. Furthermore, morphine mildly vasodilates, which increases systemic vascular resistance, decreasing the right-to-left shunt flow.
Choice E rationale
Placing the infant in the knee-chest position significantly increases systemic vascular resistance (SVR) by compressing the major arteries in the lower extremities. The increased SVR reduces the pressure gradient driving the right-to-left shunt through the ventricular septal defect, thereby increasing pulmonary blood flow and improving oxygen saturation during the hypercyanotic event.
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