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Cierra, a 10-year-old female weighing 36kg, is now NPO for surgery in the morning and needs _____ of maintenance fluids.

36ml

67.5ml

24ml

76ml

Answer and Explanation

The Correct Answer is D

Step 1: Use the Holliday-Segar formula for maintenance fluids:

For the first 10 kg: 100 mL/kg/day

For the next 10 kg: 50 mL/kg/day

For any additional kg over 20 kg: 20 mL/kg/day

Step 2: Calculate for 36 kg

First 10 kg → 10 × 100 = 1,000 mL

Next 10 kg → 10 × 50 = 500 mL

Remaining 16 kg → 16 × 20 = 320 mL

Total = 1000 + 500 + 320 = 1,820 mL/day

Step 3: Convert to hourly rate

1820 mL/day ÷ 24 hr = 75.8 mL/hr

= 76 mL/hr (rounded off to the nearest whole number.

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Correct Answer is B

Explanation

A. Kawasaki disease typically presents with fever, conjunctivitis, rash, swollen hands/feet, and lymphadenopathy, not following strep throat or with joint pain as a primary feature.
B. Rheumatic heart disease is a complication of rheumatic fever, which can follow an untreated or inadequately treated streptococcal throat infection. The child’s symptoms—fever, shortness of breath (carditis), abdominal pain, and painful swollen joint (arthritis)—are classic signs of rheumatic fever, which can lead to long-term cardiac damage.
C. Coarctation of the aorta is a congenital condition involving narrowing of the aorta and typically presents with differential blood pressure between extremities, not joint swelling or post-streptococcal symptoms.
D. Dextro-transposition of the great arteries is a cyanotic congenital heart defect that presents in newborns, not older children with post-infectious symptoms.

A. Digoxin must be administered with food. B. Only give if the child's heart rate is less than 60 beats/minute C. Observe for nausea and vomiting D. Re-dose the child if the child vomits the first dose.

Correct Answer is C

Explanation

A. Digoxin does not need to be given with food, and food may actually alter its absorption. It's best given at the same time each day, either with or without food, depending on the provider's recommendation.
B. The heart rate threshold for holding digoxin in children is generally less than 90–110 beats/min in infants and less than 70 in older children, not 60 bpm, which is the adult guideline.
C. Nausea and vomiting are early signs of digoxin toxicity. Parents should be taught to observe for these symptoms and report them immediately.
D. If a child vomits after taking digoxin, the dose should not be repeated, as it is impossible to know how much was absorbed, and repeating could cause toxicity.

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Cierra, a 10-year-old female weighing 36kg, is now NPO for surgery in the morning and needs _____ of maintenance fluids.

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Correct Answer is C

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