A nurse is caring for a pediatric patient with suspected dehydration.
The child presents with diarrhea and vomiting.
What clinical manifestations would the nurse expect to observe in this patient?

Thirst and dry mouth.

Rapid heart rate and low blood pressure.

Sunken eyes and fontanelle in infants.

Lethargy and irritability.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Thirst and dry mouth are common signs of dehydration in adults, but in pediatric patients, especially infants, the signs are different.

Children may not be able to communicate their thirst effectively, and dry mouth might not be as noticeable as other signs.

Choice B rationale:

Rapid heart rate and low blood pressure are symptoms of shock, which can occur in severe dehydration.

However, these symptoms are not specific to dehydration and can be present in other conditions.

Sunken eyes and fontanelle in infants are more specific indicators of dehydration in pediatric patients.

Sunken eyes occur due to loss of tissue turgor, and a sunken fontanelle (the soft spot on an infant's head) is a late sign of dehydration.

Choice D rationale:

Lethargy and irritability can be signs of dehydration, but they are nonspecific and can occur in various pediatric conditions.

Sunken eyes and fontanelle, on the other hand, are more specific to dehydration, especially in infants.

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Correct Answer is D

Explanation

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.

A. Normal saline (0.9% NaCl). B. Half normal saline (0.45% NaCl). C. Lactated Ringer’s. D. D5W (5% dextrose in water).

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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A nurse is caring for a pediatric patient with suspected dehydration.The child presents with diarrhea and vomiting.What clinical manifestations would the nurse expect to observe in this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is calculating maintenance fluids for a child who weighs 18 kg. According to the Holliday-Segar method, what would be the total maintenance fluid requirement for this child?

Correct Answer is D

Explanation

A client is admitted to the hospital with dehydration and hyponatremia.The nurse is preparing to start an intravenous (IV) infusion.Which of the following IV fluids is the most appropriate for this client?

Correct Answer is A

Explanation

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A nurse is caring for a pediatric patient with suspected dehydration.
The child presents with diarrhea and vomiting.
What clinical manifestations would the nurse expect to observe in this patient?