A nurse is calculating maintenance fluids for a child who weighs 18 kg.
According to the Holliday-Segar method, what would be the total maintenance fluid requirement for this child?
Total maintenance fluids = 1800 mL/day.
Total maintenance fluids = 1200 mL/day.
Total maintenance fluids = 1600 mL/day.
Total maintenance fluids = 1400 mL/day.
The Correct Answer is D
The correct answer is Choice B: Total maintenance fluids = 1200 mL/day.
Choice A rationale:
This value exceeds the calculated requirement for a child weighing 18 kg using the Holliday-Segar method.
Choice B rationale:
The Holliday-Segar method calculates maintenance fluids based on weight as follows:
- For the first 10 kg, the requirement is 100 mL/kg.
- For the next 10 kg, the requirement is 50 mL/kg.
Thus, for a child weighing 18 kg:
- First 10 kg: 10 kg x 100 mL/kg = 1000 mL
- Next 8 kg: 8 kg x 50 mL/kg = 400 mL Total maintenance fluid requirement = 1000 mL + 400 mL = 1400 mL/day.
So, actually, the correct answer should be Choice D: 1400 mL/day.
Choice C rationale:
This value is higher than the requirement for 18 kg based on the Holliday-Segar method.
Choice D rationale:
This is the correct calculation based on the method described above: 1000 mL for the first 10 kg plus 400 mL for the next 8 kg totals 1400 mL/day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Administer electrolyte solutions or supplements as prescribed by the physician.
Rationale: While administering electrolyte solutions or supplements may be part of the treatment plan for a dehydrated child, it is not the initial action that the nurse should take.
The first step should be to assess the child's condition and monitor their response to treatment.
Choice B rationale:
Monitor the child’s response to treatment and adjust the plan accordingly.
Rationale: This is The correct answer.
Dehydration is a complex condition, and the nurse's initial action should be to closely monitor the child's response to treatment, which may include oral or intravenous rehydration.
By monitoring the child's vital signs, urine output, and clinical signs, the nurse can make real-time adjustments to the treatment plan.
Choice C rationale:
Collaborate with physicians, nutritionists, and other healthcare professionals to ensure comprehensive care.
Rationale: Collaboration with other healthcare professionals is important for the overall care of the child, but it is not the immediate action needed to correct electrolyte imbalances in a dehydrated child.
Monitoring and treatment adjustments come first.
Choice D rationale:
Assess the degree of dehydration based on clinical signs and symptoms.
Rationale: While assessing the degree of dehydration is important, it should not be the only action taken.
Monitoring the child's response to treatment and adjusting the plan is equally crucial.
Dehydration assessment is typically part of the initial evaluation, but ongoing monitoring is necessary to ensure the child's condition improves.
Correct Answer is A
Explanation
Choice A rationale:
Normal saline (0.9% NaCl).
Rationale: Normal saline is the most appropriate choice for a client with dehydration and hyponatremia.
It provides a balanced solution with sodium and chloride, which can help correct hyponatremia and rehydrate the client.
It is an isotonic solution and is commonly used for fluid resuscitation.
Choice B rationale:
Half normal saline (0.45% NaCl).
Rationale: Half normal saline is also an isotonic solution, but it contains less sodium than normal saline.
In a case of hyponatremia, it's better to use a solution with a higher sodium concentration, making choice A (normal saline) more appropriate.
Choice C rationale:
Lactated Ringer’s.
Rationale: Lactated Ringer's is another isotonic solution, but it may not be the best choice for a client with hyponatremia.
It contains lactate, which can be metabolized to bicarbonate, potentially worsening the client's hyponatremia.
Therefore, it's not the most appropriate option in this case.
Choice D rationale:
D5W (5% dextrose in water).
Rationale: D5W is a hypotonic solution and should not be used for rehydration in a client with hyponatremia.
It can exacerbate the electrolyte imbalance and is not suitable for addressing dehydration.
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