A nurse is providing fluid replacement therapy to a dehydrated child.
What should the nurse do to ensure comprehensive care during the treatment and management of dehydration in children?

Choice A rationale:

Normal saline (0.9% NaCl).

Rationale: Normal saline is the most appropriate choice for a client with dehydration and hyponatremia.

It provides a balanced solution with sodium and chloride, which can help correct hyponatremia and rehydrate the client.

It is an isotonic solution and is commonly used for fluid resuscitation.

Choice B rationale:

Half normal saline (0.45% NaCl).

Rationale: Half normal saline is also an isotonic solution, but it contains less sodium than normal saline.

In a case of hyponatremia, it's better to use a solution with a higher sodium concentration, making choice A (normal saline) more appropriate.

Choice C rationale:

Lactated Ringer’s.

Rationale: Lactated Ringer's is another isotonic solution, but it may not be the best choice for a client with hyponatremia.

It contains lactate, which can be metabolized to bicarbonate, potentially worsening the client's hyponatremia.

Therefore, it's not the most appropriate option in this case.

Choice D rationale:

D5W (5% dextrose in water).

Rationale: D5W is a hypotonic solution and should not be used for rehydration in a client with hyponatremia.

It can exacerbate the electrolyte imbalance and is not suitable for addressing dehydration.

Choice A rationale:

Gastrointestinal illnesses, particularly diarrhea and vomiting, lead to fluid loss from the body.

Diarrhea can cause significant loss of water and electrolytes, leading to dehydration.

Vomiting, especially when persistent, can also result in fluid depletion.

These conditions are common causes of dehydration in both children and adults.

Choice B rationale:

Excessive sweating during physical activity or in hot weather can lead to dehydration in individuals, but this scenario does not apply to the child described in the question, who is experiencing decreased urine output and dark-colored urine.

Sweating excessively is more common in older children and adults during physical activities.

Choice C rationale:

Fever, which increases the body's fluid requirements, is a valid point.

However, the child in this scenario does not have fever mentioned as a symptom.

In the absence of fever, gastrointestinal illnesses are the more likely cause of dehydration.

Choice D rationale:

Certain medical conditions, such as diabetes or kidney disease, can lead to chronic dehydration.

However, these conditions are not mentioned in the scenario provided.

In the absence of information about underlying medical conditions, gastrointestinal illnesses remain the most likely cause of the child's dehydration.