A client is admitted to the hospital with cerebral edema.
The nurse is preparing to start an intravenous (IV) infusion.
Which of the following IV fluids is the most appropriate for this client?

Choice A rationale:

Administering oral rehydration solution (ORS) is a crucial nursing intervention for a dehydrated child.

ORS helps replenish the lost fluids and electrolytes, making it an effective treatment for dehydration.

Choice B rationale:

Keeping the child in a cold environment is not an appropriate intervention for a dehydrated child.

Dehydration is not related to room temperature, and maintaining a comfortable environment is important, but extreme cold could cause discomfort to the child.

Choice C rationale:

Monitoring the child's vital signs is an essential nursing intervention when caring for a dehydrated child.

Vital signs, including heart rate, respiratory rate, blood pressure, and temperature, can provide important information about the child's condition and hydration status.

Regular monitoring helps in assessing the child's progress and identifying any worsening symptoms.

Choice D rationale:

Providing heavy meals at regular intervals is not an appropriate intervention for a dehydrated child.

As mentioned earlier, heavy meals can be difficult to digest and may worsen dehydration.

It is more important to focus on rehydration with fluids like ORS.

Choice E rationale:

Educating the child and caregivers about dehydration is an important nursing intervention.

Teaching them about the signs and symptoms of dehydration, the importance of ORS, and how to prevent it in the future is essential for the child's well-being and for preventing future episodes of dehydration.

The correct answer is B. Shakiness.

Choice A: Increased capillary refill Capillary refill time (CRT) is a simple and quick test requiring minimal equipment or time to perform. Prolonged CRT is a ‘red flag’ feature, identifying children with increased risk of significant morbidity or mortality. A normal CRT should be between 2-3 seconds when applied centrally, such as to the sternum or the forehead. Therefore, increased capillary refill is not typically associated with hypoglycemia.

Choice B: Shakiness Shakiness, or tremors, are rhythmic shaking movements that most often happen in the hands, but can also occur in the arms, legs, head, vocal cords, and torso. Tremors can occur while a child is resting or active. Shakiness is a common symptom of hypoglycemia.

Choice C: Thirst While it’s true that excessive thirst can be a sign of diabetes, it’s a tricky one when the patient is a child. Young children often drink plenty of fluids when they are perfectly healthy. However, thirst is typically associated with hyperglycemia, not hypoglycemia.

Choice D: Decreased appetite Loss of appetite (anorexia) is a common symptom in children. Acute illness in childhood is often associated with transient loss of appetite. However, decreased appetite is not typically a direct symptom of hypoglycemia.