PN Pediatric Dehydration Case Study Test
A nurse is reinforcing discharge teaching about oral rehydration with the parent of a preschooler who has dehydration. Which of the following statements by the parent indicates an understanding of the teaching? "I will offer my child a cup of oral rehydration fluid every time he has diarrhea." "I will give my child apple juice in between meals to keep him hydrated." "I will give my child a diet of bananas, rice, applesauce, and toast until his diarrhea subsides." "I will give my child chicken broth three times each day."
-"I will offer my child a cup of oral rehydration fluid every time he has diarrhea." Stool losses should be replaced on a one to one basis with oral rehydration fluids to maintain electrolyte balances. "I will give my child apple juice in between meals to keep him hydrated." Offering fruit juices such as apple juice does not help with diarrhea because they have high osmolality and contain a high amount of carbohydrates. "I will give my child a diet of bananas, rice, applesauce, and toast until his diarrhea subsides." The BRAT diet of bananas, rice, applesauce, and toast is contraindicated for children who have acute diarrhea because the diet has little nutritional value. "I will give my child chicken broth three times each day." Chicken broth and other broths should be avoided because they contain little nutritional value and are high in sodium.
A nurse is collecting data from a 4-year-old child who has severe dehydration. Which of the following manifestations should the nurse expect? 10% weight loss Respiratory rate 18/min Capillary refill 3 seconds Urine output 24 mL/hr
-10% weight loss A child who has severe dehydration will exhibit a weight loss of 10% or greater due to the fluid loss. Respiratory rate 18/min A child who has severe dehydration will exhibit hyperpnea, which is deep and rapid respiration. Capillary refill 3 seconds A child who has severe dehydration will exhibit a delayed capillary refill of greater than 4 seconds. Urine output 24 mL/hr A urine output of 24 mL/hr is within the expected reference range for a 4-year-old child. A child who has severe dehydration will exhibit oliguria or anuria.
A nurse is caring for a preschooler who has excoriated skin related to diarrhea. Which of the following actions should the nurse take? Cleanse the area with an alkaline soap during each diaper brief change. Avoid using disposable diaper briefs until the skin has healed. Apply a thin layer of zinc oxide to the affected area during each diaper brief change. Expose the affected area to a heat lamp every 8 hr for 10 min.
-Apply a thin layer of zinc oxide to the affected area during each diaper brief change. The nurse should apply a thin layer of zinc oxide during each diaper brief change to protect the skin from moisture and further breakdown. Cleanse the area with an alkaline soap during each diaper brief change. The nurse should cleanse the affected area using a nonalkaline soap and water to remove fecal material from the skin. The nurse should avoid using alkaline soaps because they can irritate the skin. Avoid using disposable diaper briefs until the skin has healed. The nurse should use extra absorbent disposable diaper briefs to assist with keeping moisture away from the child's skin and to prevent further breakdown. Expose the affected area to a heat lamp every 8 hr for 10 min. The nurse should expose the affected area to air as often as possible to assist with keeping the area dry. A heat lamp could burn the child.
A nurse is preparing to obtain a stool specimen for Clostridium difficile from a preschooler who is wearing diaper briefs due to recent occurences of diarrhea. Which of the following actions should the nurse take? Insert the swab 2.5 cm (1 in) into the rectum for 30 seconds. Place a specimen of 2 different stools in the container for the test. Put the stool sample in a sterile container before sending it to the laboratory. Place a urinary collection bag on the child before collecting the stool specimen.
-Place a urinary collection bag on the child before collecting the stool specimen. The nurse should place a urinary collection bag on the child to avoid contaminating the stool specimen with urine. Insert the swab 2.5 cm (1 in) into the rectum for 30 seconds. The nurse should not use a swab to obtain a stool specimen for Clostridium difficile because the swab does not allow enough stool to be collected for accurate results. Place a specimen of 2 different stools in the container for the test. The nurse should not combine stool specimens in the same container. Put the stool sample in a sterile container before sending it to the laboratory. The nurse should use a clean specimen container for a stool specimen for Clostridium difficile when sending it to the laboratory.
A nurse is assisting with the admission of a preschooler who has diarrhea from an unknown cause. Which of the following actions should the nurse take? Provide 50 mL/kg of oral rehydration fluid over 4 hr. Administer polyethylene glycol electrolyte solution daily. Obtain a rectal temperature every 2 hr. Give the rotavirus vaccination orally.
-Provide 50 mL/kg of oral rehydration fluid over 4 hr. The nurse should provide the child with 50 mL/kg of oral rehydration fluid over 4 hr to rehydrate the body and reverse fluid losses from diarrhea. Administer polyethylene glycol electrolyte solution daily. Polyethylene glycol electrolyte solution is a laxative and will cause the diarrhea to worsen. Obtain a rectal temperature every 2 hr. The nurse should avoid obtaining the child's temperature rectally because it can stimulate the bowel and worsen diarrhea. Give the rotavirus vaccination orally. The rotavirus vaccination is given as a three dose series and must be completed by the age of 8 months.
