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","C","D"]
Explanation
Choice A rationale:
Lactated Ringer's solution is not contraindicated in cases of hyperkalemia.
This solution contains potassium in a relatively low concentration of 4 mEq/L, which is unlikely to significantly impact hyperkalemia.
Choice B rationale:
Lactated Ringer's solution can be contraindicated in cases of hypokalemia.
While it does contain potassium, the concentration is relatively low at 4 mEq/L.
In cases of severe hypokalemia, a more potassium-rich solution might be preferred.
Choice C rationale:
Lactated Ringer's solution can be used in cases of lower GI fluid loss.
It can help replace lost fluids and electrolytes effectively.
Choice D rationale:
Lactated Ringer's solution can be used in cases of upper GI fluid loss.
It helps restore lost fluids and electrolytes.
Choice E rationale:
Lactated Ringer's solution is not contraindicated in cases of lactic acidosis.
In fact, it contains lactate (28 mEq/L), which can be metabolized to bicarbonate and help correct acidosis.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale:
Assessing the degree of dehydration based on clinical signs and symptoms is a fundamental step in managing a dehydrated child.
This assessment guides the choice of appropriate treatment and fluid replacement.
Choice B rationale:
Calculating the fluid deficit based on the degree of dehydration is crucial in determining the amount of fluid that needs to be replaced accurately.
This calculation helps prevent under or overhydration.
Choice D rationale:
Monitoring the child's response to treatment and adjusting the plan accordingly is essential.
Dehydration management is an ongoing process, and adjustments may be necessary based on how the child is progressing.
Choice E rationale:
Communication with physicians, nutritionists, and other healthcare professionals is vital for comprehensive care.
Dehydration management often involves a multidisciplinary approach to address the child's overall health and nutritional needs.
Selecting all of these options (A, B, D, and E) ensures a comprehensive approach to managing dehydration in a child.
It involves assessment, calculation, monitoring, and collaboration with healthcare professionals for the best outcome.
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