The maintenance fluid requirement for a 25 kg child per day is

Correct Answer: D

Rationale: Rationale: The correct answer is D) 1600 ml for the maintenance fluid requirement for a 25 kg child per day. This can be calculated using the Holliday-Segar method, which recommends a daily fluid intake of 100 ml/kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 20 ml/kg for each additional kg. For a 25 kg child, this would be calculated as follows: 1000 ml (for the first 10 kg) + 500 ml (for the next 10 kg) + 300 ml (for the remaining 5 kg) = 1600 ml. Option A) 2000 ml is incorrect because it exceeds the calculated maintenance fluid requirement for a 25 kg child using the Holliday-Segar method. Option B) 1000 ml is incorrect because it only accounts for the fluid requirement for the first 10 kg of the child's weight and does not consider the additional fluid needed for the remaining 15 kg. Option C) 2500 ml is incorrect as it also exceeds the calculated maintenance fluid requirement for a 25 kg child and does not align with the recommended fluid intake based on the child's weight. Understanding the maintenance fluid requirements in pediatric nursing is crucial for providing appropriate care to children, especially in clinical settings where accurate fluid management is essential for their well-being. By knowing how to calculate and determine the correct fluid requirements based on a child's weight, nurses can ensure proper hydration and prevent complications related to fluid imbalance.

Correct Answer: D

Rationale: In pediatric nursing, understanding the characteristics of dehydration is crucial for providing effective care to children. In the case of hypertonic dehydration, the correct answer is D) Shock occurs late because of relatively preserved volume. This is because in hypertonic dehydration, there is a higher concentration of solutes outside the cells, causing water to move from inside the cells to the extracellular space, maintaining the overall volume for longer compared to isotonic dehydration. Option A) Marked loss of skin turgor while tongue is not dry is incorrect because in hypertonic dehydration, both skin turgor and mucous membranes like the tongue are likely to be dry due to the increased osmolarity of the extracellular space. Option B) Moist tongue is a late sign is incorrect because a moist tongue is not typically associated with dehydration of any type, including hypertonic dehydration. Dry mucous membranes are a common finding in dehydrated patients. Option C) CNS complications are relatively infrequent is incorrect because hypertonic dehydration can indeed lead to serious central nervous system (CNS) complications such as seizures due to the shift of water out of brain cells in response to increased osmolarity. Educationally, understanding the specific characteristics of different types of dehydration helps nurses accurately assess and manage pediatric patients. Recognizing the signs and symptoms of hypertonic dehydration can guide appropriate interventions to prevent complications and optimize outcomes for children in their care.

Correct Answer: A

Rationale: In pediatric nursing, administering medications via endotracheal tube may be necessary in emergency situations where intravenous access is not readily available. The correct answer is A) Lidocaine, naloxone, atropine, epinephrine. Lidocaine is a local anesthetic used for managing arrhythmias. Naloxone is an opioid antagonist used to reverse opioid overdose. Atropine is a medication used to increase heart rate in bradycardia. Epinephrine is a vasopressor used in cardiac arrest and anaphylaxis. These drugs can be given via endotracheal tube in appropriate doses in emergencies. Option B is incorrect as digoxin, a cardiac glycoside, is not recommended for administration via endotracheal tube due to possible complications and lack of efficacy through this route. It is crucial for pediatric nurses to be familiar with drugs that can be administered via endotracheal tube, understand their indications, dosages, and potential complications. This knowledge is vital in providing timely and effective care to critically ill pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) Viral croup. The Steeple sign refers to the characteristic subglottic narrowing seen on a frontal neck X-ray in children with viral croup. This narrowing resembles the shape of a church steeple. Understanding this sign is crucial for diagnosing and managing pediatric patients with respiratory distress. Option A) Acute epiglottitis presents with a thumbprint sign on X-ray and is a medical emergency requiring prompt intervention. Streptococcal pharyngitis (Option C) typically presents with sore throat, fever, and swollen lymph nodes, and is diagnosed through throat swab culture. Acute bronchitis (Option D) is characterized by inflammation of the bronchi and does not involve the characteristic Steeple sign. Educationally, recognizing the Steeple sign in viral croup highlights the importance of clinical assessment skills and imaging interpretation in pediatric nursing practice. Understanding these distinctions is vital for accurate diagnosis, appropriate treatment, and ensuring positive patient outcomes in pediatric respiratory conditions.

Correct Answer: C

Rationale: In pediatric nursing, understanding the peak incidence of acute bronchiolitis is crucial for providing appropriate care to infants. The correct answer is C) 2-6 months. This is because acute bronchiolitis commonly affects infants between 2 to 6 months of age due to their small airways being more susceptible to inflammation and obstruction by viruses like respiratory syncytial virus (RSV). Option A) 9-12 months is incorrect because infants in this age range are slightly older and their airways have developed a bit more, making them less vulnerable to acute bronchiolitis compared to younger infants. Option B) 6-12 months is incorrect because while some cases may occur in this age range, the peak incidence is typically earlier, between 2 to 6 months. Option D) 12-24 months is incorrect as by 12 months, most infants have outgrown the peak age range for acute bronchiolitis, though they can still be affected. Educationally, understanding the age group most at risk for acute bronchiolitis helps nurses in identifying and managing cases promptly, potentially preventing complications. It also underscores the importance of preventive measures like hand hygiene and avoiding exposure to sick individuals, especially during peak bronchiolitis season.