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 cerebral edema.
This isotonic solution is commonly used to maintain intravascular volume and provides a neutral effect on fluid balance in the brain.
It does not introduce additional electrolytes that could potentially worsen cerebral edema.
Choice B rationale:
Half normal saline (0.45% NaCl) is not the best choice for cerebral edema because it is hypotonic and may lead to cellular swelling, potentially exacerbating the edema.
Choice C rationale:
Lactated Ringer's, while isotonic, contains additional electrolytes and lactate.
In the case of cerebral edema, it is safer to use a solution with a simpler composition like normal saline to avoid any potential complications related to electrolyte imbalances.
Choice D rationale:
D5W (5% dextrose in water) is not recommended for cerebral edema because it contains dextrose and may not adequately address the underlying issue of increased intracranial pressure associated with cerebral edema.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale:
Thirst and dry mouth are early signs of dehydration.
When the body loses fluids, it signals the brain to increase thirst and conserve water.
Dry mouth can occur due to reduced saliva production when the body is dehydrated.
Choice B rationale:
Decreased urine output and dark-colored urine are indicators of concentrated urine, suggesting dehydration.
Reduced fluid intake or excessive fluid loss can lead to decreased urine production, and the urine becomes more concentrated, appearing darker than usual.
Choice C rationale:
Rapid heart rate and low blood pressure are signs of hypovolemic shock, a severe form of dehydration where the body cannot circulate enough blood to meet its needs.
This can happen in severe cases of dehydration when there is a significant loss of fluids and electrolytes.
Choice D rationale:
Poor skin turgor is a classic clinical sign of dehydration.
Skin turgor refers to the skin's ability to return to its normal position after being pinched.
In dehydrated individuals, the skin loses elasticity and remains tented or "pinched" after being pulled up.
This indicates a lack of fluid in the body.
Choice E rationale:
Increased energy and playfulness are not typical signs of dehydration.
Dehydrated children are more likely to be lethargic and irritable due to the physiological stress on their bodies.
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