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","C","E"]
Explanation
Sunken fontanelle (in infants).
C. Dry mucous membranes.
E. Lethargy.
Choice A rationale:
Sunken fontanelle (in infants) is a clinical sign of dehydration.
The fontanelle is the soft spot on an infant's head, and when it becomes sunken, it suggests that the child is dehydrated.
This occurs because a lack of adequate fluid causes the brain to temporarily shrink, leading to the sunken appearance.
Choice B rationale:
Increased urine output is not typically a sign of dehydration.
In fact, dehydration often leads to decreased urine output as the body attempts to conserve fluid.
Increased urine output can be a sign of other conditions, such as diabetes.
Choice C rationale:
Dry mucous membranes are a classic sign of dehydration.
When the body lacks sufficient fluids, the mucous membranes in the mouth and other areas can become dry and sticky.
This is an important clinical indicator of dehydration.
Choice D rationale:
Normal skin turgor is not a sign of dehydration.
Skin turgor refers to the skin's ability to bounce back when pinched and released.
In a hydrated individual, the skin should have good turgor.
Dehydration can lead to poor skin turgor, but normal skin turgor does not indicate dehydration.
Choice E rationale:
Lethargy is a potential sign of dehydration.
When a child is dehydrated, they may become lethargic or unusually tired because their body is not receiving the necessary fluids to function properly.
Lethargy can be an early sign of dehydration in children.
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