A nurse is caring for a pediatric patient with suspected dehydration.
The child presents with diarrhea and vomiting.
What clinical manifestations would the nurse expect to observe in this patient?

Choice A rationale:

Assessing the degree of dehydration based on clinical signs and symptoms is a fundamental step in managing a dehydrated child.

This assessment guides the choice of appropriate treatment and fluid replacement.

Choice B rationale:

Calculating the fluid deficit based on the degree of dehydration is crucial in determining the amount of fluid that needs to be replaced accurately.

This calculation helps prevent under or overhydration.

Choice D rationale:

Monitoring the child's response to treatment and adjusting the plan accordingly is essential.

Dehydration management is an ongoing process, and adjustments may be necessary based on how the child is progressing.

Choice E rationale:

Communication with physicians, nutritionists, and other healthcare professionals is vital for comprehensive care.

Dehydration management often involves a multidisciplinary approach to address the child's overall health and nutritional needs.

Selecting all of these options (A, B, D, and E) ensures a comprehensive approach to managing dehydration in a child.

It involves assessment, calculation, monitoring, and collaboration with healthcare professionals for the best outcome.

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.