Exam 45: The Child With Alterations in Fluid, Electrolyte, and Acid-Base Balance

A four-year-old child is admitted to the hospital secondary to dehydration. Lab tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. This fluid loss is indicative of which condition?

A nurse is taking care of four different pediatric clients. Which of the following children is at greatest risk for dehydration?

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a licensed vocational nurse (LVN), cautions the LVN to watch for which clinical manifestation?

As a result of opioid administration, a child's respirations are slow and shallow. The nurse would expect that lab changes that might be noted in response to the changes in the child's uncompensated respiratory pattern would include:

A nurse is planning care for a child with hyperkalemia. The nurse explains to the parents that an adverse outcome of hyperkalemia is:

A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the physician has ordered. The formula the physician used was for maintenance fluids: 1,000 mL for 10 kg of body weight plus 50 cc for every kg over 10 for 24 hours. Replacement fluid is the percentage of lost bodyweight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, what should this child's hourly IV rate for 24 hours be?

The nurse is evaluating an infant for dehydration. Which assessment provides the most accurate information on dehydration?

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which nursing diagnosis would take priority?

The nurse has just finished a parent teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?

A nine-month-old infant is hospitalized with vomiting and diarrhea. The mother questions why her child needed hospitalization since her school-age nephew had the same symptoms and was treated at home. The nurse would explain that an infant is more at risk for dehydration than a school-age child because:

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?

In the morning, a nurse receives a report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the nurse see first?

The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early to moderate stage of dehydration?

A child with croup has an increased pCO₂, a decreased pH, and a normal HCO₃ blood gas value. The nurse interprets this as uncompensated:

A six-year-old child is hypokalemic. The nurse is helping the child complete the menu. The nurse would encourage this child to select which menu items?