Med Surg Peds Fluid & Electrolytes

The number of milliliters of fluids a day needed for a 14kg child is:

1200 ml/day

An infant weights 9.6 kg, how much should nurse administer per hour to provide daily maintenance of IV fluid required for this child?

40 ml/hr

Three year old admitted with diarrhea and dehydration. She is NPO for bowel rest. She is ordered for IV maintenance fluids, her weight is 13 kg. You calculate her hours IV fluid rate to be approximately?

46 ml/hr

Andy is a 30kg child who is admitted to the pediatric unit with dehydration. He is currently NPO and is receiving IV fluids at maintenance. What is the hourly rate at which his IV fluids should be set?

70 ml/hr

Once Nancy is rehydrated, what is her fluid requirement if she weighs 7kg?

7kg X 100ml/kg/day = 700 ml/day

Sally has been vomiting and having diarrhea for two days. Mrs. Evans states that Sally "just hasn't been able to keep anything down." The nurse notes that Sally is very pale and has dark circles under her eyes. Sally is very lethargic and doesn't cry or move when the nurse obtains her vital signs. Which of the following should the nurse anticipate will be in Sally's plan of care? Administering an IV bolus of normal saline Administering and IV bolus with fluids containing both saline and glucose to help correct dehydration and hypoglycemia Give Sally a pedialyte popsicle to avoid traumatizing Sally with an invasive procedure. Encourage Sally's mother to attempt to give her clear liquids before starting an IV.

Administering an IV bolus of normal saline (Wouldn't give glucose because you could give the child more issues with hyperglycemia, NS is isotonic for the body.)

Five-month-old Nancy is being treated at home for mild dehydration secondary to diarrhea. An early clinical sign of dehydration is usually? Hypotension Increased urinary output Depressed anterior fontanel Capillary refill time greater than 2 seconds

Capillary refill time greater than 2 seconds

When caring for child with an IV infusion, the nurse should do which of the following? Change insertion site every 24 hours Check insertion site frequently for signs of infiltration Use a microdropper to facilitate reaching prescribed flow Avoid restraining the child to prevent undue emotional stress

Check insertion site frequently for signs of infiltration (every 1-2 hours)

The mother asks what to do about breastfeeding John. The nurse should recommend: Stop breast feeding for 24 hours Stop breast feeding until diarrhea stops Bottle food glucose water, alternating it with breast feeding Continue breast feeding and give an oral rehydration solution to replace diarrheal losses

Continue breast feeding and give an oral rehydration solution to replace diarrheal losses

Tonya is a 6 moth old female who has vomited twice this morning and has had an episode of diarrhea. All of the following are signs of mild to moderate dehydration except? Increased heart rate Sunken fontanel Dry mucous membranes Decreased blood pressure

Decreased blood pressure

Which of the following signs would the nurse recognize as an indication of moderate dehydration in a preschool child? Sunken fontanel (Preschool child, fontanels are closed) Diaphoresis Dry mucous membranes Decrease during specific gravity

Dry mucous membranes remember: Preschool child, fontanels are closed

Clinical manifestations of sodium excess (hypernatremia) include which of the following? Hyperreflexia, Abdominal cramps Cardiac dysrhythmias Dry, sticky mucous membranes

Dry, sticky mucous membranes Hyperreflexia is hyperkalemia Abdominal cramps-hyponatremia Cardiac dysrhythmias--hyper/hypokalemia

A 4-month-old infant is admitted to the unit with moderate dehydration. Which of the following symptoms does the nurse recognize as consistent with this diagnosis? Select all that apply Elevated HR Urine specific gravity of 1.038 Weight gain Polyuria Slow capillary refill

Elevated HR Urine specific gravity of 1.038 Slow capillary refill

The nurse is caring for 18-month-old Kobe who has moderate diarrhea. Kobe's plan of care should include all of the following except? Encourage Kobe to drink apple juice instead of milk Offer Kobe a snack of pretzels and bananas Ensure that all of Kobe's diapers are weighed Monitor Kobe's skin integrity around the diaper area

Encourage Kobe to drink apple juice instead of milk

Nurses must be alert for increased fluid requirement when a child has which one of the following? Fever Mechanical ventilation Congestive heart failure Increased ICP

Fever=insensible fluid loss, child has increased body surface area

Which of the following is the most appropriate method for rehydrating Tony? Administer IV fluid Give an oral rehydration solution Give soft drinks that have been diluted and decarbonated Give small amounts of gelatin or clear liquids such as juice and water

Give an oral rehydration solution

Pamela is being evaluated in the pediatric clinic. Pamela has been vomiting all morning and her mother wants to know if she is doing everything that she should be doing. Which of the following indicates she needs additional educations? I've been giving clear liquids all morning I've encouraged Pamela to rest I've been a watching to see if Pamela becomes more restless I'm keeping Pamela away from other kids in the family

I've been giving clear liquids all morning (Should be Pedialyte or oral rehydrating solution)

Which of the following factors predisposes and infant to fluid imbalances? Decrease surface area Lower metabolic rate Immature kidney function Decrease daily exchange of extracellular fluid

Immature kidney function

Which of the following factors predisposes an infant to fluid imbalances? Decreased surface area Lower metabolic rate Immature kidney function Decreased daily exchange of extracellular fluid

Immature kidney function It would be: i. Increased surface area ii. Higher metabolic rate iii. Greater exchange of extracellular fluid

Four-year-old Drew has been vomiting for 24 hours, several labs have been ordered. The nurse would expect the results to show which of the following? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis

The mother asks about giving children antidiarrheal medications. The nurses response should be based on knowledge that these medications are: Not recommended Recommended for children over age 6 Recommended for children over age 1 Recommended for children over age 4

Not recommended

The mother asks about giving Tony food after he is rehydrated. Which of the following is the most appropriate recommendations? Offer regular diet Offer regular diet except high-protein foods Give clear liquids for next 24 hours Start BRAT diet

Offer regular diet (BRAT diet is coming into question now.... though personally I still use it)

Mild dehydration is often treated at home by administering: Diluted fruit juices Water Oral rehydration fluids (solutions) Warm milk

Oral rehydration fluids (solutions) ORS

Nancy's dehydration increases and she is hospitalized with parenteral fluid therapy. Which replacement is not added until kidney function is reestablished? Magnesium Sodium Chloride Sodium bicarbonate Potassium

Potassium

A 5-year-old child weighs 18kg, the urine output has been 175ml for the past 12 hours, this indicates which of the following?

Too little urine output (216 would be the minimum over 12 hours, 1 ml/kg/hr)

An infant is brought to the ER with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia and tachypnea. This is suggestive of which of the following: Water excess Sodium excess Water depletion Potassium excess

Water depletion

An approximate method of estimating output for a child who is not toilet trained is? Have a parent estimate output Weigh diapers after each void Place urine collection device on child Have child sit on potty chair for 30 minutes after eating

Weigh diapers after each void i. 1g of weight is = 1ml of urine