A nurse is caring for a client who has suffered acute blood loss and is experiencing hypovolemia due to third-space fluid shifts.
The physician orders Lactated Ringer’s solution for fluid resuscitation.
The nurse knows that this solution contains Sodium 130 mEq/L, Chloride 109 mEq/L, Potassium 4 mEq/L, Calcium 3 mEq/L, and Lactate 28 mEq/L.
Which of the following statements are true regarding Lactated Ringer’s solution? (Select all that apply).

The correct answer is Choice B: Total maintenance fluids = 1200 mL/day.

Choice A rationale:

This value exceeds the calculated requirement for a child weighing 18 kg using the Holliday-Segar method.

Choice B rationale:

The Holliday-Segar method calculates maintenance fluids based on weight as follows:

• For the first 10 kg, the requirement is 100 mL/kg.
• For the next 10 kg, the requirement is 50 mL/kg.

Thus, for a child weighing 18 kg:

• First 10 kg: 10 kg x 100 mL/kg = 1000 mL
• Next 8 kg: 8 kg x 50 mL/kg = 400 mL Total maintenance fluid requirement = 1000 mL + 400 mL = 1400 mL/day.

So, actually, the correct answer should be Choice D: 1400 mL/day.

Choice C rationale:

This value is higher than the requirement for 18 kg based on the Holliday-Segar method.

Choice D rationale:

This is the correct calculation based on the method described above: 1000 mL for the first 10 kg plus 400 mL for the next 8 kg totals 1400 mL/day.

Choice A rationale:

"Height and weight.”.

Rationale: While monitoring height and weight is important for a child's growth and development, these parameters are not the primary vital signs to assess dehydration.

Dehydration assessment focuses on immediate physiological indicators, such as heart rate and blood pressure.

Choice B rationale:

"Heart rate and blood pressure.”.

Rationale: This is The correct answer.

When assessing a dehydrated child, monitoring vital signs such as heart rate and blood pressure is crucial.

Dehydration can lead to an increased heart rate and decreased blood pressure.

These parameters provide valuable information about the child's circulatory status and fluid balance.

Choice C rationale:

"Hair and eye color.”.

Rationale: Hair and eye color are not relevant parameters for assessing dehydration.

They are genetic traits and do not change in response to dehydration.

Choice D rationale:

"Shoe size and clothing size.”.

Rationale: Shoe size and clothing size are not relevant for assessing dehydration.

These measurements are related to a child's growth and body structure but do not provide information about their hydration status.