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The nurse is calculating maintenance IV fluid requirements for a child who weighs 48 pounds. Using the continuous fluid maintenance formula, calculate the rate (ml/hr) the nurse will set the pump?

Round to the nearest whole number. Enter the number only, no units.

Answer and Explanation

The Correct Answer is ["64"]

To calculate the maintenance IV fluid rate for a child, we typically use the Holliday-Segar formula:

For the first 10 kg of weight: 100 ml/kg/day
For the next 10 kg of weight: 50 ml/kg/day
For any additional weight: 20 ml/kg/day

The weight of the child is 48 pounds, which is approximately 21.8 kg (since 1 pound = 0.45 kg).

Using the formula:

First 10 kg: 100 ml/kg/day = 1000 ml/day
Next 10 kg: 50 ml/kg/day = 500 ml/day
Remaining 1.8 kg: 20 ml/kg/day = 36 ml/day

Total = 1000 ml + 500 ml + 36 ml = 1536 ml/day

To find the rate in ml/hr: 1536 ml/day ÷ 24 hours/day = 64 ml/hr

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Correct Answer is B

Explanation

Choice A reason: While an oxygen saturation of 94% is slightly low, it is not an immediate emergency for a child with asthma. This patient can be monitored but does not require the nurse's immediate attention.

Choice B reason: Severe chest pain in a patient with sickle cell anaemia can indicate a serious complication known as acute chest syndrome, which is a medical emergency. This condition requires immediate assessment and intervention to prevent life-threatening complications.

Choice C reason: A urine specific gravity of 1.010 indicates dilute urine, which is typical for a patient with diabetes insipidus. While this condition requires management, it is not an immediate emergency compared to severe chest pain in a sickle cell anaemia patient.

Choice D reason: A fever of 102.2°F in a child with respiratory syncytial virus (RSV) is concerning and requires attention, but it is not as immediately life-threatening as severe chest pain in a sickle cell anaemia patient. This patient can be seen after addressing the more urgent case.

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A. A 5-year-old child admitted with asthma exacerbation who used a rescue inhaler 16 hours ago. B. A 3-year-old toddler who swallowed several sunflower seeds and continues to cough with an oxygen saturation of 91%. C. A 15-year-old adolescent who had a laparoscopic appendectomy 10 hours ago, rates their pain a 3/10, and is preparing for discharge this morning. D. An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hours and ate 70% of their meals.

Correct Answer is B

Explanation

Choice A reason: While a child with asthma exacerbation needs monitoring, they used their rescue inhaler 16 hours ago and are currently stable. This patient is not the highest priority.

Choice B reason: A 3-year-old who continues to cough with an oxygen saturation of 91% is at risk of respiratory distress or obstruction due to the swallowed sunflower seeds. The low oxygen saturation indicates impaired gas exchange and requires immediate attention.

Choice C reason: A 15-year-old recovering from a laparoscopic appendectomy who is stable and preparing for discharge can wait to be seen after more urgent cases.

Choice D reason: An 18-month-old admitted for dehydration who is producing a normal number of wet diapers and eating well indicates improved hydration status and can be seen after addressing the more critical situation.

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The nurse is calculating maintenance IV fluid requirements for a child who weighs 48 pounds. Using the continuous fluid maintenance formula, calculate the rate (ml/hr) the nurse will set the pump? Round to the nearest whole number. Enter the number only, no units.

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The nurse is calculating maintenance IV fluid requirements for a child who weighs 48 pounds. Using the continuous fluid maintenance formula, calculate the rate (ml/hr) the nurse will set the pump?

Round to the nearest whole number. Enter the number only, no units.