The nurse is caring for a 12 kg toddler who is diagnosed with dehydration following a history of vomiting and diarrhea. She has received two fluid boluses and now has an order for D5/0.45 NaCl at full maintenance. After calculating daily fluid requirements, at what hourly rate would the nurse set the pump? Round to the nearest whole number and just insert the number.
The Correct Answer is ["46"]
To provide adequate hydration for a toddler with dehydration, the nurse needs to calculate the daily fluid requirements based on the child's weight and then divide it by 24 hours to get the hourly rate.
For a 12 kg toddler, the daily fluid requirement is 1000 ml for the first 10 kg plus 50 ml for each additional kg, which equals 1100 ml.
Therefore, the hourly rate is 1100 ml / 24 hours, which is about 46 ml.
The nurse would set the pump at 46 ml per hour.
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Correct Answer is D
Explanation
A. "I should keep my infected child away from his brother until he has recovered."
This statement is correct. Keeping an infected child away from siblings can help prevent the spread of bronchiolitis.
B. "I should insist that anyone who comes in contact with my children thoroughly wash their hands before playing with them."
This statement is correct. Handwashing is an important preventive measure to reduce the transmission of viruses that can cause bronchiolitis.
C. "I should insist that anyone with a respiratory illness avoid contact with my children until well."
This statement is correct. Avoiding contact with individuals who have respiratory illnesses helps reduce the risk of bronchiolitis.
D. "I should make sure both my children get a vaccination for bronchiolitis this year."
This statement needs further clarification. There isn't a specific vaccine for bronchiolitis. However, vaccination against certain viruses, such as the influenza virus (flu), can help prevent respiratory infections that may lead to bronchiolitis.
Correct Answer is C
Explanation
A. Wait for parents to obtain consent
Waiting for parents to obtain consent might not be appropriate in emergency situations where immediate intervention is necessary. Delays could impact the outcome, and the healthcare team needs to prioritize the well-being of the patient.
B. Give pain medications until consent can be obtained
Administering pain medications alone might provide temporary relief but does not address the underlying issue requiring emergency surgery. It's important to address the root cause promptly, especially if surgery is deemed necessary.
C. Have the youth give assent, and proceed with surgery
This option is appropriate when dealing with a mature minor who can understand the nature, risks, and benefits of the surgery. Assent from the youth is sought in conjunction with attempts to contact parents. It is an ethical and legal approach in emergency situations.
D. Attempt to contact another relative
Attempting to contact another relative might be a consideration, but it could introduce additional delays. If the situation is urgent and the youth can provide informed assent, proceeding with surgery while continuing efforts to contact parents is a reasonable approach.
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