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?
Administer electrolyte solutions or supplements as prescribed by the physician.
Monitor the child’s response to treatment and adjust the plan accordingly.
Collaborate with physicians, nutritionists, and other healthcare professionals to ensure comprehensive care.
Assess the degree of dehydration based on clinical signs and symptoms.
The Correct Answer is B
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.
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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.
Correct Answer is C
Explanation
“I understand that my child’s hydration status will be continuously assessed.”.
Choice A rationale:
While a child's age and weight may play a role in determining fluid replacement, this statement doesn't encompass the entire concept of managing dehydration.
Monitoring hydration status involves assessing clinical signs and symptoms, as well as ongoing evaluation.
Choice B rationale:
Electrolyte solutions and supplements are indeed part of the treatment for dehydration.
However, this statement doesn't reflect the comprehensive understanding of managing a dehydrated child, including continuous assessment of hydration status.
Choice C rationale:
This statement indicates a correct understanding.
Continuous assessment of a child's hydration status is essential in managing dehydration.
It allows healthcare providers to monitor the child's response to treatment and make necessary adjustments.
Choice D rationale:
Collaboration within the healthcare team is important, but this statement doesn't specifically address the understanding of fluid replacement and dehydration management.
The correct response is choice C because it highlights the critical aspect of continuous assessment, which is essential to ensure that the child's hydration status is being monitored effectively during treatment.
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