A 1000 mL 0.9% NS bag is to be administered to a patient at 20 mL/hr. The patient is to receive this solution for hours. How many mi will the patient receive?
(Round to the nearest whole number)

Obstructive congenital heart defects involve the presence of narrowing or constriction in various parts of the heart or major blood vessels. In the case of coarctation of the aorta, there is a narrowing or constriction in the aorta, which can obstruct blood flow. Aortic stenosis involves the narrowing of the aortic valve, and pulmonic stenosis involves the narrowing of the pulmonary valve. These defects create obstacles to the normal flow of blood out of the heart, leading to increased pressure within the heart and affecting blood circulation.

The other categories mentioned are:

B. Mixing defects: These defects involve abnormal mixing of oxygenated and deoxygenated blood within the heart, typically due to septal defects like atrial septal defect (ASD) or ventricular septal defect (VSD).

C. Decreased pulmonary blood flow: These defects are characterized by reduced blood flow to the lungs, such as in the tetralogy of Fallot.

D. Increased pulmonary blood flow: These defects involve increased blood flow to the lungs, often due to shunting of blood from the left side of the heart to the right side, as seen in atrial septal defects or ventricular septal defects.

APSGN is characterized by inflammation of the glomeruli in the kidneys, which can lead to decreased kidney function and impaired urine output. As the condition begins to improve, one of the first signs is an increase in urine output. This is because the inflammation in the glomeruli starts to resolve, allowing the kidneys to filter blood more effectively and produce a higher volume of urine.

Now, let's discuss why the other options are incorrect:

A. Increased energy levels: While improved energy levels can be a positive sign in a child recovering from an illness, they are not typically the earliest sign of improvement in APSGN. Energy levels may improve as the child's overall condition gets better, but this improvement often follows an increase in urine output.

B. Decreased diarrhea: APSGN primarily affects the kidneys, not the gastrointestinal tract. Therefore, diarrhea is not a direct symptom of this condition. Improving kidney function and urine output would not directly impact diarrhea.

D. Increased appetite: Like increased energy levels, an improved appetite can be a positive sign in recovery, but it is not typically the earliest sign of improvement in APSGN. It is generally more related to overall recovery and feeling better after the acute phase of the illness.

In summary, while all of these signs can be positive indicators of a child's recovery, increased urine output is usually the earliest and most specific sign of improvement in acute post-streptococcal glomerulonephritis, as it directly reflects the resolution of kidney dysfunction.