A nurse is caring for a child with severe dehydration who weighs 14 kg.
What would be the total hourly fluid replacement rate for this child?
Approximately 58 mL/hour.
Approximately 140 mL/hour.
Approximately 100 mL/hour.
Approximately 82 mL/hour.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Normal saline (0.9% NaCl).
Choice A rationale:
Normal saline (0.9% NaCl) is the most appropriate choice for a client with burns and hypovolemia.
This isotonic solution helps to restore intravascular volume and replace lost fluids.
It contains sodium chloride in a concentration similar to that of the body's extracellular fluid, making it effective for rehydration and replenishing electrolytes in hypovolemic patients.
Choice B rationale:
Half normal saline (0.45% NaCl) is a hypotonic solution with a lower sodium concentration than the body's extracellular fluid.
It is not the best choice for treating hypovolemia and burns because it may not effectively expand intravascular volume and may cause cellular swelling.
Choice C rationale:
Lactated Ringer's is an isotonic solution, but it contains additional electrolytes and lactate.
While it can be suitable for some fluid replacement needs, normal saline is preferred for burn patients because it has a simpler composition and is effective for volume resuscitation in cases of hypovolemia.
Choice D rationale:
D5W (5% dextrose in water) is a solution that primarily provides dextrose for energy, not suitable for hypovolemia and burns.
It can cause dilutional hyponatremia if used as the primary fluid in hypovolemic patients.
Correct Answer is B
Explanation
Choice A rationale:
Maintaining a warm room temperature is not the key to preventing dehydration.
Dehydration occurs when the body loses more fluids than it takes in, and temperature control in the room doesn't directly address this issue.
Choice B rationale:
The significance of oral rehydration solution (ORS) is a crucial factor in preventing and treating dehydration.
ORS contains a balanced mixture of salts and sugars that help the body reabsorb water and electrolytes lost due to dehydration.
It is the most effective way to rehydrate a dehydrated child.
Educating the client about the importance of ORS is essential because it provides a clear solution to the problem of dehydration.
Choice C rationale:
The need for a complete blood count (CBC) testing is unrelated to the prevention of dehydration.
CBC is a diagnostic test used to assess various blood parameters, including red and white blood cell counts.
It is not a preventive measure against dehydration.
Choice D rationale:
Suggesting the child's need for frequent, heavy meals is not an appropriate way to prevent dehydration.
In fact, heavy meals can sometimes worsen dehydration as they may be difficult to digest, leading to an increased risk of vomiting and diarrhea, which exacerbate fluid loss.
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