A nurse is assessing a child for dehydration.
Which of the following should the nurse evaluate during the physical examination?

Choice A rationale:

“This fluid will help to restore my sodium levels and replace the fluids I lost from vomiting.”.

The client should understand that they are receiving Half Normal Saline (0.45% NaCl) to restore sodium levels and replace lost fluids due to vomiting.

Half Normal Saline contains 77 mEq/L of sodium and 77 mEq/L of chloride, making it a suitable choice for a patient with mild hyponatremia and fluid loss from vomiting.

It helps restore sodium levels without the risk of overcorrection seen with 0.9% NaCl.

Choice B rationale:

“This fluid will help to lower my sodium levels and replace the fluids I lost from sweating.”.

Half Normal Saline is not used to lower sodium levels; its purpose is to restore sodium levels and provide fluids for cases like vomiting or other fluid losses.

Sweating typically leads to fluid loss, not sodium loss, and Half Normal Saline is not a treatment for high sodium levels.

Choice C rationale:

“This fluid will help to restore my potassium levels and replace the fluids I lost from vomiting.”.

Half Normal Saline does not address potassium levels, and the primary reason for using it is to address sodium imbalances and fluid loss, not potassium-related issues.

Choice D rationale:

“This fluid will help to lower my potassium levels and replace the fluids I lost from sweating.”.

Half Normal Saline is not used to lower potassium levels and is not specifically indicated for treating high potassium.

Additionally, it is not typically used to address fluid loss from sweating.

Choice A rationale:

Gastrointestinal illnesses, particularly diarrhea and vomiting, lead to fluid loss from the body.

Diarrhea can cause significant loss of water and electrolytes, leading to dehydration.

Vomiting, especially when persistent, can also result in fluid depletion.

These conditions are common causes of dehydration in both children and adults.

Choice B rationale:

Excessive sweating during physical activity or in hot weather can lead to dehydration in individuals, but this scenario does not apply to the child described in the question, who is experiencing decreased urine output and dark-colored urine.

Sweating excessively is more common in older children and adults during physical activities.

Choice C rationale:

Fever, which increases the body's fluid requirements, is a valid point.

However, the child in this scenario does not have fever mentioned as a symptom.

In the absence of fever, gastrointestinal illnesses are the more likely cause of dehydration.

Choice D rationale:

Certain medical conditions, such as diabetes or kidney disease, can lead to chronic dehydration.

However, these conditions are not mentioned in the scenario provided.

In the absence of information about underlying medical conditions, gastrointestinal illnesses remain the most likely cause of the child's dehydration.