Deck 46: The Child With Alterations in Fluids, electrolytes, and Acidbase Balance

Question 1

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)Respiratory acidosis.
B)Respiratory alkalosis.
C)Metabolic acidosis.
D)Metabolic alkalosis.

Answer 1

Respiratory acidosis.

Question 2

A nurse is planning care for a child with hyponatremia.The nurse delegating care of this child to an LVN cautions the LVN about which complication?

A)Seizures
B)Bradycardia
C)Respiratory distress
D)Hyperthermia

Answer 2

Seizures

Question 3

The neonatal nurse explains to new parents that infants are at greater risk for fluid and electrolyte imbalance than are older children.Which of the following parent comments would indicate that further education is needed?

A)"Infants have a higher metabolic rate than older children do."
B)"An infant has little body water for reserve,as compared with an adult."
C)"Infants lose water through their skin,and they have a larger proportion of skin surface area than older children do."
D)"Infants maintain their temperature by losing heat through their heads."

Answer 3

"Infants maintain their temperature by losing heat through their heads."

Question 4

A 1-month-old infant is admitted to the Emergency Department with severe diarrhea.Which assessment suggests the infant is severely dehydrated?

A)Skin moist and flushed;mucous membranes dry
B)Low specific gravity of urine;skin color pale
C)Fontanelles depressed;capillary refill greater than 3 seconds
D)High specific gravity of urine;moist mucous membranes

Question 5

A child is being treated for dehydration with intravenous fluids.The child currently weighs 13 kg,and is estimated to have lost 7% of her normal body weight.The nurse is double-checking the IV rate the physician has ordered.Replacement fluid is the percentage of lost body weight $\times$ 10 per kg of body weight.According to the calculation for maintenance and replacement fluid,this child's hourly IV rate for 24 hours should be _______.

Question 6

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)D5W
B)0.9% normal saline
C)Albumin
D)D5 0.2% (1/4)normal saline

Question 7

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

A)Hydrochlorothiazide (Aquazide)
B)Spironolactone (Aldactone)
C)Furosemide (Lasix)
D)Mannitol (Osmitrol)

Question 8

A 6-year-old child is hypokalemic.The nurse is helping the child choose menu items.The nurse would encourage this child to select which foods?

A)Hamburger with French fries
B)Pizza with a fruit plate
C)Chicken strips with chips
D)Fajita with rice

Question 9

A 6-month-old infant is admitted with severe dehydration.Effectiveness of therapy is evaluated with which of the following assessment measures? Select all that apply.

A)Record intake and output accurately.
B)Daily weights on the same scale,same time,with no clothes
C)Document mucous membrane moisture every shift.
D)Evaluate level of consciousness continuously.
E)Document abdominal girth every shift.

Question 10

In the morning,a nurse receives a report on four pediatric clients,each of whom has some form of fluid volume excess.Which child should the nurse check first? The child with:

A)Periorbital edema,normal respiratory rate.
B)Tachypnea and pulmonary congestion.
C)Dependent and sacral edema,regular pulse.
D)Hepatomegaly,normal respiratory rate.

Question 11

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 that the infant still is in the early or mild stage of dehydration?

A)Tachycardia
B)Bradycardia
C)Increased blood pressure
D)Decreased blood pressure

Question 12

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a high-concentrated formula.Which is the most appropriate response by the nurse?

A)"A higher-concentrated formula could lead to dehydration because of high sodium content.Let's discuss other strategies."
B)"An undiluted formula concentrate could be given to help the child gain weight.Let's look at brands."
C)"Evaporated milk could be given to the infant instead of the current formula you're using."
D)"A higher-concentrated formula could be given for daytime feedings.Let's work on a schedule."

Question 13

An infant is in the hospital for hypernatremia.Which of the following is the most appropriate means of collecting urine for a specific gravity test?

A)Placing cotton balls in the diaper and then (wearing gloves)squeezing a drop of urine from the cotton balls onto the specific gravity test strip
B)Performing a sterile in-and-out catheterization to collect urine for the specific gravity test strip
C)Placing a urine collection bag on the infant
D)Inserting a Foley catheter to obtain a sterile urine specimen for the specific gravity test strip

Question 14

A nurse is taking care of four different pediatric clients.The client with the greatest risk for dehydration is the child:

A)Over 2 years of age with migraine headaches.
B)Under 2 years of age with tachypnea.
C)Over 2 years of age with a broken arm.
D)Under 2 years of age with cellulitis of the left leg.

Question 15

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)"Hydration should occur at the end of an exercise session."
B)"Water is the drink of choice to replenish fluids."
C)"Wearing dark clothing during exercise is recommended."
D)"During activity,stop for fluids every 15-20 minutes."