Which nursing intervention should a nurse expect to perform on a 7-year-old child diagnosed with mild dehydration secondary to diarrhea?
Administer a bolus of intravenous (IV) fluids as ordered.
Offer clear fluids, popsicles, and gelatin as tolerated by the child.
Offer oral rehydration solution (ORS) in small, frequent amounts.
Keep the child on a strict BRAT (bananas, rice, applesauce, toast) diet.
The Correct Answer is C
Choice A rationale:
Administering a bolus of intravenous (IV) fluids might be necessary for severe dehydration, but in mild dehydration, oral rehydration is preferred as it avoids potential complications associated with IV fluids.
Choice B rationale:
Offering clear fluids, popsicles, and gelatin is appropriate, but this choice does not specifically address rehydration, which is the primary concern in mild dehydration.
Choice C rationale:
Offering oral rehydration solution (ORS) in small, frequent amounts is the most appropriate intervention for mild dehydration secondary to diarrhea. ORS contains the right balance of electrolytes and fluids to rehydrate without overwhelming the gastrointestinal tract.
Choice D rationale:
Keeping the child on a strict BRAT diet (bananas, rice, applesauce, toast) is an outdated approach. While BRAT foods can be tolerated during mild illness, they lack the necessary electrolytes and fluids to effectively rehydrate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale:
After cleft palate repair, infants should be fed pureed or soft foods to prevent trauma to the surgical site and facilitate healing. These textures minimize the risk of injury and avoid strain on the repaired area.
Choice A rationale:
Allowing the child to self-feed with a spoon can introduce solid textures prematurely and pose a risk of disrupting the surgical repair.
Choice C rationale:
Using a cup with a straw might cause suction that could negatively impact the healing surgical site, increasing the risk of complications.
Choice D rationale:
Restricting breastfeeding is not necessary for cleft palate repair. However, positioning adjustments may be needed to facilitate effective breastfeeding while minimizing stress on the surgical area.
Correct Answer is B
Explanation
Choice A rationale:
Increased respirations are not a specific symptom of increased intracranial pressure (ICP). They might occur due to other respiratory or metabolic issues.
Choice B rationale:
Widened pulse pressure (the difference between systolic and diastolic blood pressure) is a sign of increased ICP. It results from increased systolic pressure due to the body's attempt to compensate for the rising pressure within the skull.
Choice C rationale:
Prolonged capillary refill is indicative of decreased peripheral perfusion or shock, which can be caused by various factors but is not directly related to ICP.
Choice D rationale:
Decreased blood pressure is not a consistent symptom of increased ICP. In fact, widened pulse pressure is more characteristic.
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