A nurse is caring for a child with severe dehydration who weighs 14 kg.
What would be the total hourly fluid replacement rate for this child?
Approximately 58 mL/hour.
Approximately 140 mL/hour.
Approximately 100 mL/hour.
Approximately 82 mL/hour.
The Correct Answer is C
Approximately 100 mL/hour.
To calculate the total hourly fluid replacement rate, we can use the Holliday-Segar method, which is commonly used in pediatrics.
According to this method, a child's daily maintenance fluid requirement is calculated as follows: For the first 10 kg of body weight: 100 mL/kg/day.
For the next 10 kg of body weight: 50 mL/kg/day.
For each additional kg of body weight: 20 mL/kg/day.
In this case, the child weighs 14 kg.
So, we calculate as follows: For the first 10 kg: 10 kg x 100 mL/kg/day = 1000 mL/day.
For the next 4 kg (14 kg - 10 kg): 4 kg x 50 mL/kg/day = 200 mL/day.
Now, add these two together: 1000 mL/day + 200 mL/day = 1200 mL/day.
To find the hourly rate, we divide the daily requirement by 24 (hours in a day): 1200 mL/day ÷ 24 hours/day = 50 mL/hour.
So, the child's total hourly fluid replacement rate should be approximately 50 mL/hour.
However, this is an approximate rate.
To be more conservative in the case of severe dehydration, it's common to round this up to approximately 100 mL/hour to ensure that the child receives adequate fluids to rehydrate.
Choice A rationale:
Approximately 58 mL/hour is not The correct answer.
This calculation does not match the standard Holliday-Segar method used in pediatrics for fluid replacement.
Choice B rationale:
Approximately 140 mL/hour is not The correct answer.
This calculation significantly exceeds the recommended hourly fluid replacement rate for a child of this weight, which could potentially lead to overhydration.
Choice D rationale:
Approximately 82 mL/hour is not The correct answer.
This calculation does not align with the standard method for calculating fluid replacement in pediatric patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale:
Assessing the degree of dehydration based on clinical signs and symptoms is a fundamental step in managing a dehydrated child.
This assessment guides the choice of appropriate treatment and fluid replacement.
Choice B rationale:
Calculating the fluid deficit based on the degree of dehydration is crucial in determining the amount of fluid that needs to be replaced accurately.
This calculation helps prevent under or overhydration.
Choice D rationale:
Monitoring the child's response to treatment and adjusting the plan accordingly is essential.
Dehydration management is an ongoing process, and adjustments may be necessary based on how the child is progressing.
Choice E rationale:
Communication with physicians, nutritionists, and other healthcare professionals is vital for comprehensive care.
Dehydration management often involves a multidisciplinary approach to address the child's overall health and nutritional needs.
Selecting all of these options (A, B, D, and E) ensures a comprehensive approach to managing dehydration in a child.
It involves assessment, calculation, monitoring, and collaboration with healthcare professionals for the best outcome.
Correct Answer is A
Explanation
Choice A rationale:
Normal saline (0.9% NaCl).
Rationale: Normal saline is the most appropriate choice for a client with dehydration and hyponatremia.
It provides a balanced solution with sodium and chloride, which can help correct hyponatremia and rehydrate the client.
It is an isotonic solution and is commonly used for fluid resuscitation.
Choice B rationale:
Half normal saline (0.45% NaCl).
Rationale: Half normal saline is also an isotonic solution, but it contains less sodium than normal saline.
In a case of hyponatremia, it's better to use a solution with a higher sodium concentration, making choice A (normal saline) more appropriate.
Choice C rationale:
Lactated Ringer’s.
Rationale: Lactated Ringer's is another isotonic solution, but it may not be the best choice for a client with hyponatremia.
It contains lactate, which can be metabolized to bicarbonate, potentially worsening the client's hyponatremia.
Therefore, it's not the most appropriate option in this case.
Choice D rationale:
D5W (5% dextrose in water).
Rationale: D5W is a hypotonic solution and should not be used for rehydration in a client with hyponatremia.
It can exacerbate the electrolyte imbalance and is not suitable for addressing dehydration.
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