Calculate a bolus rate (mL/kg/hour) to be given to a severely dehydrated child with diarrhea weighing 23 kg over 60 minutes. The pulse will be checked after the bolus.

Choice A reason:

Offering peanut butter and water is not the best immediate action for treating hypoglycemia. Peanut butter is a protein-rich food that takes longer to digest and does not quickly raise blood sugar levels. Water does not contain any carbohydrates and will not help in raising blood sugar levels.

Choice B Reason:

Giving one tablespoon of ice cream is not the most effective way to treat hypoglycemia. While ice cream contains sugar, it also has fat, which slows down the absorption of sugar into the bloodstream. This delay can prevent the rapid correction of low blood sugar levels.

Choice C Reason:

Giving a hard candy lollipop to lick can provide some sugar, but it is not the most efficient method for quickly raising blood sugar levels. The amount of sugar in a lollipop may not be sufficient to correct hypoglycemia, and the slow consumption may delay the necessary rise in blood sugar.

Choice D Reason:

Providing 1/2 cup of juice followed by cheese with a cracker is the best action for treating hypoglycemia. Juice contains fast-acting carbohydrates that can quickly raise blood sugar levels. Following it with cheese and a cracker provides protein and fat, which help stabilize blood sugar levels and prevent them from dropping again.

Choice A reason:

Reducing blood pressure is not a primary management goal for nephrotic syndrome in children. While hypertension can be a complication of nephrotic syndrome, the main focus of treatment is on managing proteinuria, edema, and preventing complications. Blood pressure management may be necessary, but it is not the primary goal.

Choice B reason:

Increasing the excretion of urinary protein is not a desired goal in the management of nephrotic syndrome. In fact, one of the main objectives is to reduce proteinuria (excessive protein in the urine) because it leads to hypoalbuminemia (low levels of albumin in the blood) and edema. Therefore, increasing urinary protein excretion would worsen the condition.

Choice C reason:

Increasing the ability of tissues to retain fluid is not a management goal for nephrotic syndrome. The condition is characterized by edema due to fluid retention, and the goal is to reduce this edema by managing proteinuria and using diuretics if necessary. Therefore, increasing fluid retention would be counterproductive.

Choice D reason:

Reducing the excretion of urinary protein is a primary management goal for nephrotic syndrome1. Proteinuria is a hallmark of the condition, and reducing it helps to alleviate hypoalbuminemia and edema. Treatment often includes corticosteroids to reduce inflammation and protein leakage, as well as other medications to manage symptoms and prevent complications.