Nurses must be alert for increased fluid requirements when a child has:
Mechanical ventilation
Increased intracranial pressure (ICP)
Congestive heart failure
Fever
The Correct Answer is D
Choice A reason: Mechanical ventilation does not necessarily increase the fluid requirements of a child. Mechanical ventilation is a method of providing artificial breathing support to a child who has respiratory failure or insufficiency. Mechanical ventilation may affect the fluid balance of a child by altering the insensible losses, the renal function, or the hemodynamics. However, the net effect may vary depending on the type, mode, and settings of the ventilator, as well as the underlying condition of the child. Therefore, the fluid requirements of a child on mechanical ventilation should be individualized and monitored closely¹.
Choice B reason: Increased intracranial pressure (ICP) does not increase the fluid requirements of a child. Increased ICP is a condition in which the pressure inside the skull is higher than normal, due to various causes such as head injury, brain tumor, infection, or hydrocephalus. Increased ICP may affect the fluid balance of a child by impairing the cerebral blood flow, the cerebrospinal fluid drainage, or the hypothalamic-pituitary axis. However, the net effect may vary depending on the severity, duration, and cause of the increased ICP, as well as the presence of other complications such as cerebral edema or diabetes insipidus. Therefore, the fluid requirements of a child with increased ICP should be individualized and monitored closely².
Choice C reason: Congestive heart failure does not increase the fluid requirements of a child. Congestive heart failure is a condition in which the heart is unable to pump enough blood to meet the body's needs, due to various causes such as congenital heart defects, cardiomyopathy, or infection. Congestive heart failure may affect the fluid balance of a child by causing fluid retention, edema, or pulmonary congestion. However, the net effect may vary depending on the type, severity, and stage of the heart failure, as well as the presence of other complications such as renal failure or liver failure. Therefore, the fluid requirements of a child with congestive heart failure should be individualized and monitored closely³.
Choice D reason: Fever increases the fluid requirements of a child. Fever is a condition in which the body temperature is higher than normal, due to various causes such as infection, inflammation, or immunization. Fever increases the fluid requirements of a child by increasing the metabolic rate, the insensible losses, and the urine output. The amount of fluid loss due to fever depends on the degree and duration of the fever, as well as the ambient temperature and humidity. A general rule of thumb is that for every degree Celsius increase in body temperature, the fluid requirements increase by 10%⁴. Therefore, the fluid requirements of a child with fever should be adjusted and monitored closely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Making the patient NPO (nothing by mouth) is not an appropriate intervention for CHF. NPO status may be indicated for other reasons, such as before surgery or certain tests, but it does not address the fluid overload or poor cardiac function that causes CHF.
Choice B reason: Administering diuretics is a common and effective intervention for CHF. Diuretics help reduce the excess fluid in the body and lungs, which improves breathing and lowers blood pressure. Diuretics also decrease the workload of the heart and prevent further damage to the cardiac muscles.
Choice C reason: Administering antipyretics is not a specific intervention for CHF. Antipyretics are used to lower fever, which may or may not be present in CHF. Fever may indicate an infection, which can worsen CHF, but antipyretics alone do not treat the underlying cause of the infection or the CHF.
Choice D reason: Providing IV bolus is not a recommended intervention for CHF. IV bolus is a rapid infusion of fluid or medication into the bloodstream. This may increase the fluid volume and pressure in the body and lungs, which can exacerbate CHF and cause pulmonary edema. IV bolus may be used for other conditions, such as hypovolemic shock or dehydration, but not for CHF.
Correct Answer is D
Explanation
Choice A reason: This is not a correct recommendation, as oil may not be effective in killing lice or nits. Oil may also make the hair greasy and difficult to comb.
Choice B reason: This is not a necessary recommendation, as throwing away all stuffed animals may be wasteful and upsetting for the child. Stuffed animals can be treated by sealing them in plastic bags for two weeks or by putting them in a dryer on high heat for 20 minutes¹.
Choice C reason: This is a good recommendation, as thorough cleaning of brushes, hats, and linens can help prevent the spread of lice to other people or items. However, staying home until there are no more nits is not required, as nits are not contagious and do not pose a health risk².
Choice D reason: This is the best recommendation, as applying a pediculicide and thoroughly combing the nits out of the hair can effectively treat lice infestation. Pediculicides are medicated shampoos or lotions that kill lice and some nits. Combing the nits out of the hair can remove any remaining eggs and prevent reinfestation¹².
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