Try Naxlex NCLEX-RN (Free-Trial)

A nurse is caring for a child who has been admitted with severe dehydration.
The nurse understands that the child’s degree of dehydration is typically classified based on the loss of body weight.
The nurse observes dry mucous membranes, decreased urine output, and decreased skin turgor in the child.
Based on these observations, the nurse should classify the child’s dehydration as:.

“Mild dehydration, which is 3-5% loss of body weight.”.

“Moderate dehydration, which is 6-9% loss of body weight.”.

“Severe dehydration, which is ≥10% loss of body weight.”.

“No dehydration, which is less than 3% loss of body weight.”..

Answer and Explanation

The Correct Answer is C

“Severe dehydration, which is ≥10% loss of body weight.”.

Choice A rationale:

Mild dehydration is typically classified as a 3-5% loss of body weight.

The signs and symptoms described in the scenario, such as dry mucous membranes, decreased urine output, and decreased skin turgor, are indicative of more severe dehydration than a 3-5% loss.

Choice B rationale:

Moderate dehydration is generally considered to be a 6-9% loss of body weight.

However, the signs and symptoms presented in the scenario suggest a more severe state of dehydration.

Choice C rationale:

Severe dehydration is classified as a loss of ≥10% of body weight.

The signs and symptoms observed by the nurse, including dry mucous membranes, decreased urine output, and decreased skin turgor, are consistent with severe dehydration, making choice C The correct classification.

Choice D rationale:

No dehydration is defined as less than a 3% loss of body weight.

The clinical manifestations observed in the child, as described in the scenario, clearly indicate dehydration.

In this case, the child's signs and symptoms align with the classification of severe dehydration, which is characterized by a loss of ≥10% of body weight.

These symptoms include dry mucous membranes, decreased urine output, and decreased skin turgor.

It's crucial to recognize the severity of dehydration accurately to initiate the appropriate treatment and prevent complications.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

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.

A. Total maintenance fluids = 1800 mL/day. B. Total maintenance fluids = 1200 mL/day. C. Total maintenance fluids = 1600 mL/day. D. Total maintenance fluids = 1400 mL/day.

Correct Answer is D

Explanation

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.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["B","C","D"]

Explanation

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?

Correct Answer is D

Explanation

A nurse is providing interventions for a dehydrated child.Select all appropriate nursing interventions from the following options (A-E).

A client is about to receive D10W (10% dextrose in water) as part of their treatment plan.The nurse explains that this intravenous fluid contains Dextrose 100 g/L and Water 900 mL.Which of the following statements made by the client indicates a correct understanding of their treatment?

A nurse is caring for a dehydrated child and needs to correct electrolyte imbalances as part of the treatment plan.Which of the following actions should be taken by the nurse?

A nurse is caring for a child with moderate dehydration.What is the appropriate fluid deficit calculation for a child who weighs 12 kg?

A client is concerned about their child's dehydration and seeks medical advice.The child is lethargic and irritable.What diagnostic evaluations might the healthcare provider perform to assess the child's condition, as mentioned in the text?

A nurse is caring for a pediatric patient with suspected dehydration.The child presents with diarrhea and vomiting.What clinical manifestations would the nurse expect to observe in this patient?

A client is admitted to the hospital with dehydration and hyponatremia.The nurse is preparing to start an intravenous (IV) infusion.Which of the following IV fluids is the most appropriate for this client?