A nurse is assessing a dehydrated child's vital signs.
What parameters should the nurse monitor?

Communicate with the healthcare team.

To ensure comprehensive care during the treatment and management of dehydration in children, communication with the healthcare team is essential.

Here's the rationale for this choice:

Choice A rationale:

Administer electrolyte solutions only.

This is not The correct approach.

While administering electrolyte solutions is a vital part of managing dehydration, it is not the only aspect of care.

Comprehensive care also includes assessing the child's overall condition, monitoring vital signs, and addressing any underlying causes of dehydration.

Choice B rationale:

Communicate with the healthcare team.

This is The correct answer.

Dehydration management often requires a multidisciplinary approach.

Communicating with the healthcare team, which may include physicians, dietitians, and other specialists, is crucial to ensure that the child receives appropriate treatment and that any underlying medical issues are addressed.

It also allows for coordinated care and adjustment of the treatment plan as needed.

Choice C rationale:

Rely solely on clinical signs to assess hydration status.

Relying solely on clinical signs is not sufficient for comprehensive care.

While clinical signs are important indicators of hydration status, laboratory tests and monitoring are also necessary to accurately assess and manage dehydration.

Choice D rationale:

Skip monitoring the child's response to treatment.

Skipping monitoring is not advisable.

Monitoring the child's response to treatment is a critical part of dehydration management.

It helps ensure that the child is improving, and adjustments can be made to the treatment plan if necessary.

Approximately 100 mL/hour.

To calculate the total hourly fluid replacement rate, we can use the Holliday-Segar method, which is commonly used in pediatrics.

According to this method, a child's daily maintenance fluid requirement is calculated as follows: For the first 10 kg of body weight: 100 mL/kg/day.

For the next 10 kg of body weight: 50 mL/kg/day.

For each additional kg of body weight: 20 mL/kg/day.

In this case, the child weighs 14 kg.

So, we calculate as follows: For the first 10 kg: 10 kg x 100 mL/kg/day = 1000 mL/day.

For the next 4 kg (14 kg - 10 kg): 4 kg x 50 mL/kg/day = 200 mL/day.

Now, add these two together: 1000 mL/day + 200 mL/day = 1200 mL/day.

To find the hourly rate, we divide the daily requirement by 24 (hours in a day): 1200 mL/day ÷ 24 hours/day = 50 mL/hour.

So, the child's total hourly fluid replacement rate should be approximately 50 mL/hour.

However, this is an approximate rate.

To be more conservative in the case of severe dehydration, it's common to round this up to approximately 100 mL/hour to ensure that the child receives adequate fluids to rehydrate.

Choice A rationale:

Approximately 58 mL/hour is not The correct answer.

This calculation does not match the standard Holliday-Segar method used in pediatrics for fluid replacement.

Choice B rationale:

Approximately 140 mL/hour is not The correct answer.

This calculation significantly exceeds the recommended hourly fluid replacement rate for a child of this weight, which could potentially lead to overhydration.

Choice D rationale:

Approximately 82 mL/hour is not The correct answer.

This calculation does not align with the standard method for calculating fluid replacement in pediatric patients.