Physiologically, the child compensates for fluid volume losses by which mechanism?

Correct Answer: C

Rationale: In pediatric patients, compensating for fluid volume losses involves shifting fluid from the interstitial space to the intravascular space. This mechanism helps to maintain blood volume and perfusion to vital organs. Option A, inhibition of aldosterone secretion, is incorrect because aldosterone is typically released to retain sodium and water, not to compensate for fluid losses. Option B, hemoconcentration to reduce cardiac workload, is incorrect because hemoconcentration actually occurs as a result of fluid volume depletion, not as a compensatory mechanism. Option D, vasodilation of peripheral arterioles to increase perfusion, is incorrect because vasodilation typically occurs in response to factors like decreased oxygen levels, not specifically to compensate for fluid volume losses. Educationally, understanding how children compensate for fluid volume losses is crucial in pediatric nursing care to assess and manage fluid imbalances effectively. Teaching this concept helps nurses provide optimal care to pediatric patients with fluid volume issues.

Correct Answer: D

Rationale: In pediatric nursing, assessing fluid status in infants is crucial as they are more vulnerable to fluid imbalances. The correct answer, option D, "Dry mucous membranes and generally ill appearance," is indicative of significant fluid deficit of at least 5% in an infant. Dry mucous membranes suggest dehydration, while a generally ill appearance reflects systemic compromise due to fluid loss. Option A, "Weight loss and decreased heart rate," are non-specific and can occur in various conditions, not specifically indicative of fluid deficit. Option B, "Capillary refill of less than 2 seconds and no tears," are signs of hydration status but not specific to predicting a 5% fluid deficit. Option C, "Increased skin elasticity and sunken anterior fontanel," are signs of dehydration but not as reliable in predicting a 5% fluid deficit. Educationally, it's important for nursing students to understand the specific signs and symptoms that indicate significant fluid deficits in infants to provide timely and appropriate interventions to prevent complications associated with dehydration. Understanding these nuanced clinical cues helps enhance the quality of care provided to pediatric patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Irritability and seizures. Water intoxication in infants is a serious condition that can occur when there is an excessive intake of fluids, leading to a dilution of electrolytes in the body. Infants are particularly vulnerable to water intoxication due to their small size and immature renal function. Irritability and seizures are suggestive clinical manifestations of water intoxication in infants. Irritability can be an early sign of cerebral edema, which can result from the shift of water into brain cells due to low electrolyte levels. Seizures can occur due to changes in brain function caused by electrolyte imbalances. Option A) Oliguria, is incorrect because oliguria refers to decreased urine output and is not typically seen in water intoxication where there is an excess of fluid intake. Option B) Weight loss is incorrect as water intoxication is characterized by fluid overload, leading to weight gain rather than weight loss. Option D) Muscle weakness and cardiac dysrhythmias are more commonly associated with electrolyte imbalances such as hyponatremia or hypokalemia, which can occur as a result of water intoxication, but they are not as specific to water intoxication as irritability and seizures. Educationally, it is crucial for nurses to be able to recognize the signs and symptoms of water intoxication in infants to prevent serious complications. Monitoring intake and output, as well as assessing for clinical manifestations like irritability and seizures, are essential nursing responsibilities in caring for infants receiving intravenous fluids.

Correct Answer: D

Rationale: In this question, the correct answer is D) Metabolic and respiratory alkalosis. Alkalosis refers to a condition where the body's pH is higher than normal, leading to overexcitability of the nervous system. Both metabolic and respiratory alkalosis can cause an increase in nerve excitability, leading to symptoms such as nervousness, tetany, and overexcitability. Metabolic acidosis (option A) and respiratory alkalosis (option B) would not produce the clinical manifestations described in the question. Metabolic acidosis would actually have the opposite effect, causing depression of the central nervous system. Respiratory alkalosis, on the other hand, would lead to symptoms like dizziness and tingling, rather than overexcitability of the nervous system. Educationally, understanding the relationship between acid-base imbalances and nervous system manifestations is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of alkalosis can help nurses intervene promptly to prevent complications and provide appropriate care for children experiencing these physiological disturbances.

Correct Answer: B

Rationale: Estimating output for a non-toilet trained child is crucial in pediatric nursing care to monitor fluid balance and assess for potential health issues. The correct answer is B) Weigh diapers after each void because it provides an indirect but accurate measure of urine output. By weighing the diapers before and after each void, healthcare providers can estimate the amount of urine produced by the child. Option A) Have parents estimate output, may not be reliable as parental estimations can vary widely and may not provide accurate measurements for clinical assessment. Option C) Placing a urine collection device on the child can be invasive, uncomfortable for the child, and may not be practical for continuous monitoring of output. Option D) Having the child sit on a potty chair 30 minutes after eating does not provide a method for accurately measuring output and may not be feasible for all children, especially those who are not toilet trained. In the context of pediatric nursing care, accurate measurement of urine output is essential for assessing hydration status, kidney function, and overall health of the child. Using the method of weighing diapers provides a non-invasive and practical way to estimate output in non-toilet trained children, ensuring effective monitoring and timely intervention when needed.