A pediatric patient who has been seriously burned is being given IV fluid replacements. It has been determined that the patient will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received:

12 ounces of IV fluid replacement by 6:00 PM.

12 ounces of IV fluid replacement by 4:00 PM.

18 ounces of IV fluid replacement by 4:00 PM.

18 ounces of IV fluid replacement by 6:00 PM.

Answer and Explanation

The Correct Answer is A

Choice A reason: Burn fluid replacement follows the Parkland formula, with half the total volume (24 ounces = 12 ounces) given in the first 8 hours. From 10:00 AM to 6:00 PM (8 hours), the child receives 12 ounces, aligning with pediatric burn care protocols, making this the correct choice.

Choice B reason: By 4:00 PM (6 hours), the child receives less than half the 24 ounces, as half (12 ounces) is given over 8 hours. The 12-ounce mark is reached by 6:00 PM, making this incorrect, as it overestimates fluid delivery in the shorter timeframe for burn treatment.

Choice C reason: 18 ounces by 4:00 PM (6 hours) exceeds the standard rate, as only half (12 ounces) of 24 ounces is given in 8 hours. The correct amount is 12 ounces by 6:00 PM, making this incorrect for burn fluid replacement timing in the pediatric patient’s treatment.

Choice D reason: 18 ounces by 6:00 PM (8 hours) is incorrect, as only half the total (12 ounces) is administered in the first 8 hours per burn protocols. The correct volume is 12 ounces, making this incorrect for the standard fluid replacement schedule in pediatric burn care.

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Correct Answer is D

Explanation

Choice A reason: Weighing the child monitors fluid retention but is less urgent than blood pressure, which assesses hypertensive encephalopathy risk post-convulsion in glomerulonephritis. Immediate blood pressure data guides treatment, making this secondary and incorrect compared to evaluating the child’s neurological status after a seizure.

Choice B reason: Giving fluids without guidance risks worsening fluid overload in glomerulonephritis, and delayed reporting is unsafe post-convulsion. Blood pressure assessment is critical, making this inappropriate and incorrect compared to the urgent need for immediate data to address the child’s seizure episode effectively.

Choice C reason: Administering a diuretic without provider orders is unsafe post-convulsion, as it may not address the seizure’s cause. Blood pressure evaluation informs treatment, making this risky and incorrect compared to the priority of assessing hypertension in the child with glomerulonephritis immediately.

Choice D reason: Taking blood pressure post-convulsion assesses for hypertension, a common seizure cause in glomerulonephritis, guiding urgent treatment. Reporting immediately ensures timely intervention, aligning with pediatric nephrology protocols, making this the correct action for the caregiver to take in this emergency situation.

A. Repeat the signs and symptoms over and over until they seem to understand. B. Instruct them to treat the reaction as if it’s hypoglycemia, since this condition is more likely. C. Give the caregivers educational pamphlets and videos about diabetes. D. Suggest that the child wear an insulin pump for continuous insulin administration.

Correct Answer is B

Explanation

Choice A reason: Repeating symptoms may help but doesn’t provide immediate emergency guidance, risking delay in critical situations. Treating as hypoglycemia ensures rapid response, making this less practical and incorrect compared to a clear action plan for the caregivers’ concerns about diabetes emergencies.

Choice B reason: Instructing to treat unclear reactions as hypoglycemia prioritizes rapid glucose administration, which is safer and more urgent than mistreating hyperglycemia. This aligns with pediatric diabetes emergency protocols, making it the best initial response to ensure the child’s safety in potential crises.

Choice C reason: Providing pamphlets and videos educates long-term but doesn’t address immediate emergency response needs. Treating as hypoglycemia offers clear guidance, making this supplementary and incorrect compared to the urgent action needed to manage the caregivers’ fears about diabetes emergencies.

Choice D reason: Suggesting an insulin pump addresses insulin delivery, not symptom recognition or emergency response. Treating as hypoglycemia ensures safety in crises, making this irrelevant and incorrect compared to the immediate guidance needed for the caregivers’ concerns about handling diabetes emergencies.

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Naxlex Comprehensive Predictor Exams

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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