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 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 ["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.
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