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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?

A.

Approximately 58 mL/hour.

B.

Approximately 140 mL/hour.

C.

Approximately 100 mL/hour.

D.

Approximately 82 mL/hour.

Answer and Explanation

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.


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Related Questions

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.

Correct Answer is ["A","C","E"]

Explanation

Choice A rationale:

Administering oral rehydration solution (ORS) is a crucial nursing intervention for a dehydrated child.

ORS helps replenish the lost fluids and electrolytes, making it an effective treatment for dehydration.

Choice B rationale:

Keeping the child in a cold environment is not an appropriate intervention for a dehydrated child.

Dehydration is not related to room temperature, and maintaining a comfortable environment is important, but extreme cold could cause discomfort to the child.

Choice C rationale:

Monitoring the child's vital signs is an essential nursing intervention when caring for a dehydrated child.

Vital signs, including heart rate, respiratory rate, blood pressure, and temperature, can provide important information about the child's condition and hydration status.

Regular monitoring helps in assessing the child's progress and identifying any worsening symptoms.

Choice D rationale:

Providing heavy meals at regular intervals is not an appropriate intervention for a dehydrated child.

As mentioned earlier, heavy meals can be difficult to digest and may worsen dehydration.

It is more important to focus on rehydration with fluids like ORS.

Choice E rationale:

Educating the child and caregivers about dehydration is an important nursing intervention.

Teaching them about the signs and symptoms of dehydration, the importance of ORS, and how to prevent it in the future is essential for the child's well-being and for preventing future episodes of dehydration.

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