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.

Choice A rationale:

Gastrointestinal illnesses, particularly diarrhea and vomiting, lead to fluid loss from the body.

Diarrhea can cause significant loss of water and electrolytes, leading to dehydration.

Vomiting, especially when persistent, can also result in fluid depletion.

These conditions are common causes of dehydration in both children and adults.

Choice B rationale:

Excessive sweating during physical activity or in hot weather can lead to dehydration in individuals, but this scenario does not apply to the child described in the question, who is experiencing decreased urine output and dark-colored urine.

Sweating excessively is more common in older children and adults during physical activities.

Choice C rationale:

Fever, which increases the body's fluid requirements, is a valid point.

However, the child in this scenario does not have fever mentioned as a symptom.

In the absence of fever, gastrointestinal illnesses are the more likely cause of dehydration.

Choice D rationale:

Certain medical conditions, such as diabetes or kidney disease, can lead to chronic dehydration.

However, these conditions are not mentioned in the scenario provided.

In the absence of information about underlying medical conditions, gastrointestinal illnesses remain the most likely cause of the child's dehydration.

Choice A rationale:

Thirst and dry mouth are early signs of dehydration.

When the body loses fluids, it signals the brain to increase thirst and conserve water.

Dry mouth can occur due to reduced saliva production when the body is dehydrated.

Choice B rationale:

Decreased urine output and dark-colored urine are indicators of concentrated urine, suggesting dehydration.

Reduced fluid intake or excessive fluid loss can lead to decreased urine production, and the urine becomes more concentrated, appearing darker than usual.

Choice C rationale:

Rapid heart rate and low blood pressure are signs of hypovolemic shock, a severe form of dehydration where the body cannot circulate enough blood to meet its needs.

This can happen in severe cases of dehydration when there is a significant loss of fluids and electrolytes.

Choice D rationale:

Poor skin turgor is a classic clinical sign of dehydration.

Skin turgor refers to the skin's ability to return to its normal position after being pinched.

In dehydrated individuals, the skin loses elasticity and remains tented or "pinched" after being pulled up.

This indicates a lack of fluid in the body.

Choice E rationale:

Increased energy and playfulness are not typical signs of dehydration.

Dehydrated children are more likely to be lethargic and irritable due to the physiological stress on their bodies.

Choice A rationale:

Vital signs are essential in assessing dehydration.

An elevated heart rate may indicate compensatory mechanisms due to decreased intravascular volume.

Low blood pressure may suggest severe dehydration, and abnormal temperature may indicate an underlying infection.

These parameters provide crucial information about the child's circulatory status, helping to assess the severity of dehydration.

Choice B rationale:

Physical examination findings, such as skin turgor and mucous membrane moisture, are valuable indicators of dehydration.

Poor skin turgor, where the skin doesn't return to its normal position promptly when pinched, indicates decreased tissue turgor due to fluid loss.

Dry mucous membranes, including the mouth, suggest dehydration and help evaluate the extent of fluid deficit.

These signs offer direct visual clues about the child's hydration status.

Choice C rationale:

Laboratory tests play a significant role in diagnosing dehydration.

A complete blood count (CBC) helps identify elevated hematocrit levels, indicating hemoconcentration due to fluid loss.

Electrolyte levels, specifically sodium and potassium, provide insights into the child's electrolyte balance, which can be disrupted in dehydration.

Urine specific gravity measures the kidney's ability to concentrate urine; a high specific gravity suggests concentrated urine due to reduced fluid intake.

These tests aid in confirming the diagnosis and assessing the severity of dehydration.

Choice D rationale:

Assessing the child's history is fundamental in understanding the underlying cause of dehydration.

Recent fluid intake and urine output patterns help determine the balance between intake and output.

Symptoms such as diarrhea, vomiting, and fever indicate potential causes of fluid loss.

Additionally, evaluating the child's overall health and any recent illnesses provides context for the dehydration, guiding appropriate treatment.

Choice A rationale:

Gastrointestinal illnesses, including diarrhea and vomiting, lead to fluid loss, significantly contributing to dehydration in children.

Diarrhea increases water and electrolyte loss from the body, while vomiting leads to rapid fluid depletion.

These conditions can be severe, especially in infants and young children, making them prone to dehydration.

Choice B rationale:

Excessive sweating during physical activity or in hot weather can result in significant fluid loss.

Children, especially when engaged in vigorous activities, can sweat profusely, leading to dehydration, especially if fluid intake does not match the loss.

Monitoring fluid balance is crucial during such situations to prevent dehydration-related complications.

Choice C rationale:

Insufficient fluid intake due to poor feeding or decreased thirst perception can lead to dehydration, especially in infants and young children who rely heavily on fluid intake for their hydration needs.

Children may not recognize their thirst or may refuse to drink due to illness, leading to decreased fluid intake.

This can result in dehydration, emphasizing the importance of assessing feeding habits and fluid intake patterns.

Choice D rationale:

Sunken eyes and fontanelle in infants are physical signs of dehydration, not etiological factors.

Sunken eyes are due to decreased tissue turgor, indicating dehydration.

Fontanelle, the soft spot on an infant's head, can appear sunken in dehydration.

These signs are crucial in assessing the severity of dehydration during physical examination but do not contribute to the causes of dehydration.

Choice A rationale:

"The child's favorite foods and beverages" are not relevant when assessing dehydration.

While dietary habits are essential for overall health, they do not provide information about the child's hydration status.

Choice B rationale:

"The child's school attendance and activities" are unrelated to the assessment of dehydration.

School attendance and activities are important for a child's social and educational development but do not provide any insight into the child's fluid balance or hydration status.

Choice C rationale:

"The child's skin turgor and mucous membranes" are crucial indicators of dehydration during physical examination.

Poor skin turgor, where the skin tents or remains elevated after being pinched, suggests decreased tissue elasticity due to fluid loss.

Dry mucous membranes, including the mouth, indicate dehydration.

These signs provide immediate visual clues about the child's hydration status and guide further assessment and intervention.

Choice D rationale:

"The child's vaccination history" is not relevant to the assessment of dehydration.

While vaccination history is essential for preventive healthcare, it does not provide any information about the child's current hydration status or fluid balance.

Choice A rationale:

Maintaining a warm room temperature is not the key to preventing dehydration.

Dehydration occurs when the body loses more fluids than it takes in, and temperature control in the room doesn't directly address this issue.

Choice B rationale:

The significance of oral rehydration solution (ORS) is a crucial factor in preventing and treating dehydration.

ORS contains a balanced mixture of salts and sugars that help the body reabsorb water and electrolytes lost due to dehydration.

It is the most effective way to rehydrate a dehydrated child.

Educating the client about the importance of ORS is essential because it provides a clear solution to the problem of dehydration.

Choice C rationale:

The need for a complete blood count (CBC) testing is unrelated to the prevention of dehydration.

CBC is a diagnostic test used to assess various blood parameters, including red and white blood cell counts.

It is not a preventive measure against dehydration.

Choice D rationale:

Suggesting the child's need for frequent, heavy meals is not an appropriate way to prevent dehydration.

In fact, heavy meals can sometimes worsen dehydration as they may be difficult to digest, leading to an increased risk of vomiting and diarrhea, which exacerbate fluid loss.

Choice A rationale:

Administering oral rehydration solution (ORS) is a crucial nursing intervention for a dehydrated child.

ORS helps replenish the lost fluids and electrolytes, making it an effective treatment for dehydration.

Choice B rationale:

Keeping the child in a cold environment is not an appropriate intervention for a dehydrated child.

Dehydration is not related to room temperature, and maintaining a comfortable environment is important, but extreme cold could cause discomfort to the child.

Choice C rationale:

Monitoring the child's vital signs is an essential nursing intervention when caring for a dehydrated child.

Vital signs, including heart rate, respiratory rate, blood pressure, and temperature, can provide important information about the child's condition and hydration status.

Regular monitoring helps in assessing the child's progress and identifying any worsening symptoms.

Choice D rationale:

Providing heavy meals at regular intervals is not an appropriate intervention for a dehydrated child.

As mentioned earlier, heavy meals can be difficult to digest and may worsen dehydration.

It is more important to focus on rehydration with fluids like ORS.

Choice E rationale:

Educating the child and caregivers about dehydration is an important nursing intervention.

Teaching them about the signs and symptoms of dehydration, the importance of ORS, and how to prevent it in the future is essential for the child's well-being and for preventing future episodes of dehydration.

Choice A rationale:

Lethargy and muscle weakness are common signs of electrolyte imbalances in a dehydrated child.

Dehydration can lead to an imbalance of electrolytes, such as sodium and potassium, which affects muscle function and overall energy levels.

Choice B rationale:

Increased appetite and hyperactivity are not typical signs of electrolyte imbalances in a dehydrated child.

Dehydration often leads to a decreased appetite and lethargy.

Choice C rationale:

Shortness of breath and coughing are not directly related to electrolyte imbalances in a dehydrated child.

These symptoms are more likely to be associated with respiratory or pulmonary issues rather than dehydration.

Choice D rationale:

Excessive thirst and urination are common signs of dehydration but are not indicative of electrolyte imbalances.

These symptoms occur as the body attempts to compensate for fluid loss by increasing thirst and increasing urine output.

Electrolyte imbalances are more likely to manifest as muscle weakness and cardiac arrhythmias.

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.

Choice A rationale:

Fluid deficit (in mL) = body weight (in kg) x 0.03.

Rationale: This calculation significantly underestimates the fluid deficit for a child with moderate dehydration.

Dehydration often requires more significant fluid replacement.

Choice B rationale:

Fluid deficit (in mL) = body weight (in kg) x 0.06.

Rationale: This calculation overestimates the fluid deficit for a child with moderate dehydration.

Using this formula would result in excessive fluid replacement, which can be harmful.

Choice C rationale:

Fluid deficit (in mL) = body weight (in kg) x 0.1.

Rationale: This calculation overestimates the fluid deficit for a child with moderate dehydration.

Using this formula would result in excessive fluid replacement, which can be harmful.

Choice D rationale:

Fluid deficit (in mL) = body weight (in kg) x 0.04.

Rationale: This is The correct answer.

The appropriate fluid deficit calculation for a child who weighs 12 kg with moderate dehydration is to multiply their body weight by 0.04.

For this child, it would be 12 kg x 0.04 = 480 mL.

This formula is a commonly used guideline to estimate fluid deficit in cases of dehydration.

Choice A rationale:

Total maintenance fluids = 1800 mL/day.

Rationale: According to the Holliday-Segar method, the total maintenance fluid requirement for a child who weighs 18 kg would be approximately 100 mL/kg/day.

In this case, it would be 18 kg x 100 mL/kg/day = 1800 mL/day.

Choice B rationale:

Total maintenance fluids = 1200 mL/day.

Rationale: This calculation significantly underestimates the total maintenance fluid requirement.

Children generally require a higher amount of maintenance fluids to support their growth and physiological functions.

Choice C rationale:

Total maintenance fluids = 1600 mL/day.

Rationale: This calculation underestimates the total maintenance fluid requirement.

According to the Holliday-Segar method, children typically need a maintenance fluid intake of around 100 mL/kg/day.

Choice D rationale:

Total maintenance fluids = 1400 mL/day.

Rationale: This calculation underestimates the total maintenance fluid requirement.

According to the Holliday-Segar method, the recommended maintenance fluid intake is approximately 100 mL/kg/day.

For an 18 kg child, this would be 18 kg x 100 mL/kg/day = 1800 mL/day.

“Severe dehydration, which is ≥10% loss of body weight.”.

Choice A rationale:

Mild dehydration is typically classified as a 3-5% loss of body weight.

The signs and symptoms described in the scenario, such as dry mucous membranes, decreased urine output, and decreased skin turgor, are indicative of more severe dehydration than a 3-5% loss.

Choice B rationale:

Moderate dehydration is generally considered to be a 6-9% loss of body weight.

However, the signs and symptoms presented in the scenario suggest a more severe state of dehydration.

Choice C rationale:

Severe dehydration is classified as a loss of ≥10% of body weight.

The signs and symptoms observed by the nurse, including dry mucous membranes, decreased urine output, and decreased skin turgor, are consistent with severe dehydration, making choice C The correct classification.

Choice D rationale:

No dehydration is defined as less than a 3% loss of body weight.

The clinical manifestations observed in the child, as described in the scenario, clearly indicate dehydration.

In this case, the child's signs and symptoms align with the classification of severe dehydration, which is characterized by a loss of ≥10% of body weight.

These symptoms include dry mucous membranes, decreased urine output, and decreased skin turgor.

It's crucial to recognize the severity of dehydration accurately to initiate the appropriate treatment and prevent complications.

“I understand that my child’s hydration status will be continuously assessed.”.

Choice A rationale:

While a child's age and weight may play a role in determining fluid replacement, this statement doesn't encompass the entire concept of managing dehydration.

Monitoring hydration status involves assessing clinical signs and symptoms, as well as ongoing evaluation.

Choice B rationale:

Electrolyte solutions and supplements are indeed part of the treatment for dehydration.

However, this statement doesn't reflect the comprehensive understanding of managing a dehydrated child, including continuous assessment of hydration status.

Choice C rationale:

This statement indicates a correct understanding.

Continuous assessment of a child's hydration status is essential in managing dehydration.

It allows healthcare providers to monitor the child's response to treatment and make necessary adjustments.

Choice D rationale:

Collaboration within the healthcare team is important, but this statement doesn't specifically address the understanding of fluid replacement and dehydration management.

The correct response is choice C because it highlights the critical aspect of continuous assessment, which is essential to ensure that the child's hydration status is being monitored effectively during treatment.

Choice A rationale:

Assessing the degree of dehydration based on clinical signs and symptoms is a fundamental step in managing a dehydrated child.

This assessment guides the choice of appropriate treatment and fluid replacement.

Choice B rationale:

Calculating the fluid deficit based on the degree of dehydration is crucial in determining the amount of fluid that needs to be replaced accurately.

This calculation helps prevent under or overhydration.

Choice D rationale:

Monitoring the child's response to treatment and adjusting the plan accordingly is essential.

Dehydration management is an ongoing process, and adjustments may be necessary based on how the child is progressing.

Choice E rationale:

Communication with physicians, nutritionists, and other healthcare professionals is vital for comprehensive care.

Dehydration management often involves a multidisciplinary approach to address the child's overall health and nutritional needs.

Selecting all of these options (A, B, D, and E) ensures a comprehensive approach to managing dehydration in a child.

It involves assessment, calculation, monitoring, and collaboration with healthcare professionals for the best outcome.

Choice A rationale:

Administer electrolyte solutions or supplements as prescribed by the physician.

Rationale: While administering electrolyte solutions or supplements may be part of the treatment plan for a dehydrated child, it is not the initial action that the nurse should take.

The first step should be to assess the child's condition and monitor their response to treatment.

Choice B rationale:

Monitor the child’s response to treatment and adjust the plan accordingly.

Rationale: This is The correct answer.

Dehydration is a complex condition, and the nurse's initial action should be to closely monitor the child's response to treatment, which may include oral or intravenous rehydration.

By monitoring the child's vital signs, urine output, and clinical signs, the nurse can make real-time adjustments to the treatment plan.

Choice C rationale:

Collaborate with physicians, nutritionists, and other healthcare professionals to ensure comprehensive care.

Rationale: Collaboration with other healthcare professionals is important for the overall care of the child, but it is not the immediate action needed to correct electrolyte imbalances in a dehydrated child.

Monitoring and treatment adjustments come first.

Choice D rationale:

Assess the degree of dehydration based on clinical signs and symptoms.

Rationale: While assessing the degree of dehydration is important, it should not be the only action taken.

Monitoring the child's response to treatment and adjusting the plan is equally crucial.

Dehydration assessment is typically part of the initial evaluation, but ongoing monitoring is necessary to ensure the child's condition improves.

Choice A rationale:

Ensure appropriate fluid intake based on age and weight.

Rationale: This is an essential piece of advice to prevent dehydration in children.

Proper fluid intake based on age and weight helps maintain hydration.

However, it's not the only advice that should be given.

Choice B rationale:

Monitor for signs of dehydration such as dry mucous membranes and decreased urine output.

Rationale: Monitoring for signs of dehydration is crucial, but it's not the only preventive measure.

Detecting dehydration early is important for timely intervention, but proactive prevention is also necessary.

Choice C rationale:

Encourage consumption of electrolyte solutions during periods of illness.

Rationale: Encouraging the consumption of electrolyte solutions during illness is a valuable piece of advice, especially when children may lose fluids due to vomiting or diarrhea.

However, it's not the only preventive measure.

Choice D rationale:

All these measures are necessary to prevent dehydration in children.

Rationale: This is The correct answer.

Preventing dehydration in children involves a combination of measures, including ensuring appropriate fluid intake, monitoring for signs of dehydration, and encouraging electrolyte solutions during illness.

All these measures work together to keep a child well-hydrated and prevent dehydration.

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.

Normal saline (0.9% NaCl).

Choice A rationale:

Normal saline (0.9% NaCl) is the most appropriate choice for a client with burns and hypovolemia.

This isotonic solution helps to restore intravascular volume and replace lost fluids.

It contains sodium chloride in a concentration similar to that of the body's extracellular fluid, making it effective for rehydration and replenishing electrolytes in hypovolemic patients.

Choice B rationale:

Half normal saline (0.45% NaCl) is a hypotonic solution with a lower sodium concentration than the body's extracellular fluid.

It is not the best choice for treating hypovolemia and burns because it may not effectively expand intravascular volume and may cause cellular swelling.

Choice C rationale:

Lactated Ringer's is an isotonic solution, but it contains additional electrolytes and lactate.

While it can be suitable for some fluid replacement needs, normal saline is preferred for burn patients because it has a simpler composition and is effective for volume resuscitation in cases of hypovolemia.

Choice D rationale:

D5W (5% dextrose in water) is a solution that primarily provides dextrose for energy, not suitable for hypovolemia and burns.

It can cause dilutional hyponatremia if used as the primary fluid in hypovolemic patients.

Normal saline (0.9% NaCl).

Choice A rationale:

For a client with severe hypoglycemia and unconsciousness, the priority is to provide a fluid that will rapidly raise blood sugar levels.

Normal saline is the appropriate choice because it does not contain dextrose and will not lower blood glucose levels further.

It helps maintain blood pressure and intravascular volume.

Choice B rationale:

Half normal saline (0.45% NaCl) is not the best choice for this scenario as it does not provide glucose to correct hypoglycemia.

It could be used for volume resuscitation but should be combined with a glucose source for this specific client.

Choice C rationale:

Lactated Ringer's is not ideal for treating hypoglycemia because it does not contain glucose.

It is more suitable for patients with fluid deficits but not for rapidly correcting hypoglycemia.

Choice D rationale:

D50W (50% dextrose in water) is too concentrated and could lead to rapid increases in blood sugar levels, potentially causing hyperglycemia.

It is typically reserved for situations where very rapid correction of severe hypoglycemia is necessary and can be administered in a controlled manner.

Choice E rationale:

D10W (10% dextrose in water) contains a lower concentration of dextrose compared to D50W, but it is still too concentrated for this scenario and may lead to overly rapid correction of hypoglycemia.

Normal saline is the preferred choice because it does not contain dextrose and allows for more controlled glucose administration.

Normal saline (0.9% NaCl).

Choice A rationale:

Normal saline (0.9% NaCl) is the most appropriate choice for a client with cerebral edema.

This isotonic solution is commonly used to maintain intravascular volume and provides a neutral effect on fluid balance in the brain.

It does not introduce additional electrolytes that could potentially worsen cerebral edema.

Choice B rationale:

Half normal saline (0.45% NaCl) is not the best choice for cerebral edema because it is hypotonic and may lead to cellular swelling, potentially exacerbating the edema.

Choice C rationale:

Lactated Ringer's, while isotonic, contains additional electrolytes and lactate.

In the case of cerebral edema, it is safer to use a solution with a simpler composition like normal saline to avoid any potential complications related to electrolyte imbalances.

Choice D rationale:

D5W (5% dextrose in water) is not recommended for cerebral edema because it contains dextrose and may not adequately address the underlying issue of increased intracranial pressure associated with cerebral edema.

Choice A rationale:

Albumin (5% or 25%) Albumin is the most appropriate IV fluid for a client with hypoalbuminemia and shock.

Albumin is a colloid solution that helps to increase oncotic pressure, which can be decreased in conditions like hypoalbuminemia.

This increased oncotic pressure can help draw fluids back into the vascular space, improving intravascular volume and blood pressure.

Therefore, it is a suitable choice for a patient with shock.

The two concentrations mentioned, 5% and 25%, refer to the percentage of albumin in the solution, and the choice between them depends on the severity of the patient's condition and the desired effect.

The 5% solution is often used for volume expansion and to improve hemodynamics, while the 25% solution is used for rapid volume expansion.

Choice B rationale:

Dextrans (Dextran-40 or Dextran-70) Dextrans are another type of colloid solution, but they are not the best choice for this specific situation.

Dextrans are often used as volume expanders but are more commonly employed in conditions where there is no issue with albumin levels.

In this case, the primary concern is hypoalbuminemia, and using albumin-based solutions would be more appropriate.

Choice C rationale:

Gelatin (Gelofusine or Haemaccel) Gelatin-based solutions are also colloids and can be used for volume expansion.

However, they are not the best choice for a patient with hypoalbuminemia because they do not address the low albumin levels.

Albumin solutions are preferred in such cases to help restore oncotic pressure and improve intravascular volume.

Choice D rationale:

Plasma protein fraction (Plasmanate or Plasmasteril) Plasma protein fraction solutions, also known as human albumin, are similar to albumin solutions.

However, in this context, albumin solutions are more commonly used.

Plasma protein fraction solutions may be indicated in specific situations, but the primary choice for a patient with hypoalbuminemia and shock would be albumin-based solutions, as they are specifically designed to address albumin deficiencies.

Choice A rationale:

“This fluid will help to increase your sodium levels which are currently too low.”.

The nurse should explain to the client that they are receiving Normal Saline (0.9% NaCl) to increase their sodium levels.

This is The correct choice because Normal Saline is a hypertonic solution containing 154 mEq/L of sodium and 154 mEq/L of chloride.

It is used in cases of hyponatremia to raise sodium levels.

Sodium is an essential electrolyte, and low levels can lead to symptoms such as weakness, confusion, and muscle cramps.

Choice B rationale:

“This fluid will help to decrease your sodium levels which are currently too high.”.

Normal Saline is a hypertonic solution that would not be used to lower sodium levels, as it would have the opposite effect and further elevate sodium levels.

Choice C rationale:

“This fluid will help to increase your potassium levels which are currently too low.”.

It is not used to increase potassium levels, and potassium replacement would require a different solution, such as potassium chloride.

Choice D rationale:

“This fluid will help to decrease your potassium levels which are currently too high.”.

Normal Saline does not address high potassium levels; it is used to address hyponatremia and dehydration by increasing sodium levels.

Choice A rationale:

“This fluid will help to restore my sodium levels and replace the fluids I lost from vomiting.”.

The client should understand that they are receiving Half Normal Saline (0.45% NaCl) to restore sodium levels and replace lost fluids due to vomiting.

Half Normal Saline contains 77 mEq/L of sodium and 77 mEq/L of chloride, making it a suitable choice for a patient with mild hyponatremia and fluid loss from vomiting.

It helps restore sodium levels without the risk of overcorrection seen with 0.9% NaCl.

Choice B rationale:

“This fluid will help to lower my sodium levels and replace the fluids I lost from sweating.”.

Half Normal Saline is not used to lower sodium levels; its purpose is to restore sodium levels and provide fluids for cases like vomiting or other fluid losses.

Sweating typically leads to fluid loss, not sodium loss, and Half Normal Saline is not a treatment for high sodium levels.

Choice C rationale:

“This fluid will help to restore my potassium levels and replace the fluids I lost from vomiting.”.

Half Normal Saline does not address potassium levels, and the primary reason for using it is to address sodium imbalances and fluid loss, not potassium-related issues.

Choice D rationale:

“This fluid will help to lower my potassium levels and replace the fluids I lost from sweating.”.

Half Normal Saline is not used to lower potassium levels and is not specifically indicated for treating high potassium.

Additionally, it is not typically used to address fluid loss from sweating.

Choice A rationale:

Lactated Ringer's solution is not contraindicated in cases of hyperkalemia.

This solution contains potassium in a relatively low concentration of 4 mEq/L, which is unlikely to significantly impact hyperkalemia.

Choice B rationale:

Lactated Ringer's solution can be contraindicated in cases of hypokalemia.

While it does contain potassium, the concentration is relatively low at 4 mEq/L.

In cases of severe hypokalemia, a more potassium-rich solution might be preferred.

Choice C rationale:

Lactated Ringer's solution can be used in cases of lower GI fluid loss.

It can help replace lost fluids and electrolytes effectively.

Choice D rationale:

Lactated Ringer's solution can be used in cases of upper GI fluid loss.

It helps restore lost fluids and electrolytes.

Choice E rationale:

Lactated Ringer's solution is not contraindicated in cases of lactic acidosis.

In fact, it contains lactate (28 mEq/L), which can be metabolized to bicarbonate and help correct acidosis.

Choice A rationale:

The client's statement, "This IV fluid will provide me with hydration and calories," is correct.

D10W contains 10% dextrose and is used to provide both hydration and calories to the patient.

Choice B rationale:

D10W would not help lower blood sugar levels.

In fact, it would increase blood sugar levels due to the high concentration of dextrose.

Choice C rationale:

D10W does not provide essential electrolytes, so the statement is incorrect.

It's primarily used for calorie supplementation and hydration.

Choice D rationale:

D10W would not help increase blood pressure.

While it can provide hydration, it does not contain medications or components specifically intended to increase blood pressure.

Sunken fontanelle (in infants).

C. Dry mucous membranes.

E. Lethargy.

Choice A rationale:

Sunken fontanelle (in infants) is a clinical sign of dehydration.

The fontanelle is the soft spot on an infant's head, and when it becomes sunken, it suggests that the child is dehydrated.

This occurs because a lack of adequate fluid causes the brain to temporarily shrink, leading to the sunken appearance.

Choice B rationale:

Increased urine output is not typically a sign of dehydration.

In fact, dehydration often leads to decreased urine output as the body attempts to conserve fluid.

Increased urine output can be a sign of other conditions, such as diabetes.

Choice C rationale:

Dry mucous membranes are a classic sign of dehydration.

When the body lacks sufficient fluids, the mucous membranes in the mouth and other areas can become dry and sticky.

This is an important clinical indicator of dehydration.

Choice D rationale:

Normal skin turgor is not a sign of dehydration.

Skin turgor refers to the skin's ability to bounce back when pinched and released.

In a hydrated individual, the skin should have good turgor.

Dehydration can lead to poor skin turgor, but normal skin turgor does not indicate dehydration.

Choice E rationale:

Lethargy is a potential sign of dehydration.

When a child is dehydrated, they may become lethargic or unusually tired because their body is not receiving the necessary fluids to function properly.

Lethargy can be an early sign of dehydration in children.

Approximately 100 mL/hour.

To calculate the total hourly fluid replacement rate, we can use the Holliday-Segar method, which is commonly used in pediatrics.

According to this method, a child's daily maintenance fluid requirement is calculated as follows: For the first 10 kg of body weight: 100 mL/kg/day.

For the next 10 kg of body weight: 50 mL/kg/day.

For each additional kg of body weight: 20 mL/kg/day.

In this case, the child weighs 14 kg.

So, we calculate as follows: For the first 10 kg: 10 kg x 100 mL/kg/day = 1000 mL/day.

For the next 4 kg (14 kg - 10 kg): 4 kg x 50 mL/kg/day = 200 mL/day.

Now, add these two together: 1000 mL/day + 200 mL/day = 1200 mL/day.

To find the hourly rate, we divide the daily requirement by 24 (hours in a day): 1200 mL/day ÷ 24 hours/day = 50 mL/hour.

So, the child's total hourly fluid replacement rate should be approximately 50 mL/hour.

However, this is an approximate rate.

To be more conservative in the case of severe dehydration, it's common to round this up to approximately 100 mL/hour to ensure that the child receives adequate fluids to rehydrate.

Choice A rationale:

Approximately 58 mL/hour is not The correct answer.

This calculation does not match the standard Holliday-Segar method used in pediatrics for fluid replacement.

Choice B rationale:

Approximately 140 mL/hour is not The correct answer.

This calculation significantly exceeds the recommended hourly fluid replacement rate for a child of this weight, which could potentially lead to overhydration.

Choice D rationale:

Approximately 82 mL/hour is not The correct answer.

This calculation does not align with the standard method for calculating fluid replacement in pediatric patients.

Communicate with the healthcare team.

To ensure comprehensive care during the treatment and management of dehydration in children, communication with the healthcare team is essential.

Here's the rationale for this choice:

Choice A rationale:

Administer electrolyte solutions only.

This is not The correct approach.

While administering electrolyte solutions is a vital part of managing dehydration, it is not the only aspect of care.

Comprehensive care also includes assessing the child's overall condition, monitoring vital signs, and addressing any underlying causes of dehydration.

Choice B rationale:

Communicate with the healthcare team.

This is The correct answer.

Dehydration management often requires a multidisciplinary approach.

Communicating with the healthcare team, which may include physicians, dietitians, and other specialists, is crucial to ensure that the child receives appropriate treatment and that any underlying medical issues are addressed.

It also allows for coordinated care and adjustment of the treatment plan as needed.

Choice C rationale:

Rely solely on clinical signs to assess hydration status.

Relying solely on clinical signs is not sufficient for comprehensive care.

While clinical signs are important indicators of hydration status, laboratory tests and monitoring are also necessary to accurately assess and manage dehydration.

Choice D rationale:

Skip monitoring the child's response to treatment.

Skipping monitoring is not advisable.

Monitoring the child's response to treatment is a critical part of dehydration management.

It helps ensure that the child is improving, and adjustments can be made to the treatment plan if necessary.