What is the required number of milliliters of fluid needed per day for a 14-kg child?

Correct Answer: D

Rationale: In pediatric nursing, calculating the required daily fluid intake for a child is crucial to maintain proper hydration and support metabolic functions. The correct answer, option D (1400 ml), is determined using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for every kilogram above 20 kg. For a 14-kg child, the calculation would be: (10 kg x 100 ml/kg) + (4 kg x 50 ml/kg) = 1000 ml + 200 ml = 1200 ml + 200 ml (for the extra 4 kg above 10 kg) = 1400 ml/day. Option A (800 ml) is too low for a 14-kg child and would not meet the child's fluid needs, potentially leading to dehydration. Option B (1000 ml) does not account for the additional 4 kg above 10 kg, resulting in an insufficient intake. Option C (1200 ml) does not consider the incremental increase needed for each kilogram above 10 kg, leading to an inadequate fluid volume for the child. Understanding how to calculate pediatric fluid requirements is essential for nurses caring for children to ensure optimal health outcomes and prevent complications related to fluid imbalances. This knowledge helps nurses provide safe and effective care by meeting the unique physiological needs of pediatric patients.

Correct Answer: D

Rationale: In the context of pediatric nursing care, understanding the clinical manifestations of sodium excess (hypernatremia) is crucial for providing safe and effective care to children. The correct answer is D) Dry, sticky mucous membranes. Dry, sticky mucous membranes are a common sign of hypernatremia because excessive sodium levels in the body can lead to dehydration and water imbalances. Children with hypernatremia may exhibit signs of dehydration such as dry mouth, decreased urine output, and dry mucous membranes. Option A) Hyperreflexia is not typically associated with hypernatremia. Hyperreflexia is more commonly seen in conditions such as hypercalcemia or spinal cord injury. Option B) Abdominal cramps are not a typical clinical manifestation of hypernatremia. Abdominal cramps may be seen in conditions like gastroenteritis or constipation. Option C) Cardiac dysrhythmias are not a common sign of hypernatremia. Instead, cardiac dysrhythmias may be seen in conditions such as electrolyte imbalances like hyperkalemia or hypokalemia. Educationally, understanding the clinical manifestations of hypernatremia helps nurses in early identification and intervention to prevent complications in pediatric patients. Monitoring for signs like dry, sticky mucous membranes can prompt timely interventions such as fluid resuscitation and electrolyte management.

Correct Answer: A

Rationale: In a child with an excess of water, the nurse should expect a decreased hematocrit. This is because an excess of water dilutes the blood, leading to a lower concentration of red blood cells in the plasma, resulting in a decreased hematocrit level. Option A is correct because excess water intake can lead to hemodilution, causing a decrease in hematocrit levels. This is a direct physiological response to increased water in the body. Option B, high serum osmolality, would be seen in conditions of dehydration or when there is a deficit of water in the body, not in a child with an excess of water. Option C, high urine specific gravity, is also seen in dehydration when the body tries to conserve water. In a child with an excess of water, the urine specific gravity would be low due to the high volume of dilute urine being produced. Option D, increased blood urea nitrogen (BUN), typically indicates dehydration or impaired kidney function, not an excess of water. Understanding these laboratory findings in relation to fluid balance is crucial in pediatric nursing care to assess and manage children's hydration status accurately. Nurses must be able to interpret these results to provide appropriate interventions and ensure optimal patient outcomes.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the clinical manifestations of hypocalcemia is crucial for providing safe and effective care to children. The correct answer, "D) Neuromuscular irritability," is associated with calcium depletion because low levels of calcium can lead to increased neuromuscular excitability, manifesting as muscle twitching, spasms, and tetany. Option A, "Nausea, vomiting," is not typically associated with hypocalcemia but may be seen in conditions like gastroenteritis or food poisoning. Option B, "Weakness, fatigue," is more commonly linked to conditions like anemia or electrolyte imbalances other than hypocalcemia. Option C, "Muscle hypotonicity," is not a typical presentation of hypocalcemia; instead, it is more indicative of conditions like hypokalemia or hypomagnesemia. Educationally, understanding the specific clinical manifestations of hypocalcemia in children is essential for early recognition and intervention. By knowing that neuromuscular irritability is a key sign of calcium depletion, nurses can promptly assess, monitor, and implement appropriate treatment measures to prevent potential complications and promote optimal health outcomes in pediatric patients.

Correct Answer: B

Rationale: In this question from the ATI RN Nursing Care of Children exam, the correct answer is B) Hypotonic dehydration. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit. In this type of dehydration, there is a greater loss of electrolytes compared to water, leading to an imbalance where the concentration of solutes outside the cell is lower than inside the cell. This can result in cellular swelling and potentially dangerous shifts in fluid balance. Option A) Isotonic dehydration is incorrect because in isotonic dehydration, there is an equal loss of water and electrolytes, maintaining a balance in solute concentration inside and outside the cell. Option C) Hypertonic dehydration is also incorrect as it occurs when there is a greater loss of water compared to electrolytes, leading to an increased concentration of solutes outside the cell, causing cells to shrink. Option D) Hyperosmotic dehydration is not a recognized term in dehydration classification and is not a valid option in this context. Understanding the different types of dehydration is crucial for nurses caring for children, as dehydration is a common issue in pediatric patients, especially in cases of vomiting, diarrhea, or inadequate fluid intake. Recognizing the type of dehydration is essential for providing appropriate treatment and preventing complications. Nurses must be able to assess electrolyte imbalances and fluid status accurately to intervene effectively in pediatric dehydration cases.