Which diet would the nurse recommend to the mother of a child who is having mild
diarrhea?
a. Rice, potatoes, yogurt, cereal, and cooked carrots
b. Bananas, rice, applesauce, and toast
c. Apple juice, hamburger, and salad
d. Whatever the child would like to eat - ANS: A
Rationale;
A Bland but nutritious foods including complex carbohydrates (rice, wheat,
potatoes, cereals), yogurt, cooked vegetables, and lean meats are recommended
to prevent dehydration and hasten recovery.
B These foods used to be recommended for diarrhea (BRAT diet). These foods are
easily tolerated, but the BRAT diet is low in energy, density, fat, and protein.
C Fatty foods, spicy foods, and foods high in simple sugars should be avoided.
D The child should be offered foods he or she likes but should not be encouraged
to eat fatty foods, spicy foods, and foods high in simple sugars.
Which assessment findings indicate to the nurse that a child has excess fluid volume?
Select all that apply.
a. Weight gain
, 2
b. Decreased blood pressure
c. Moist breath sounds
d. Poor skin turgor
e. Rapid bounding pulse - ANS: A, C, E
Rationale;
Correct: A child with fluid volume excess will have a weight gain, moist breath
sounds due to the excess fluid in the pulmonary system, and a rapid
bounding pulse. Other signs seen with fluid volume excess are increased
blood pressure, edema, and fatigue.
Incorrect: Decreased blood pressure and poor skin turgor are signs of fluid volume
deficit.
Bodily fluids are composed of two elements; water and _____. - Correct Answer - ANS:
Solutes
Rationale;
Water is the primary constituent of bodily fluids. An infant's weight is approximately 75%
water compared to the adult's weight, which is 55% to 60% water. Solutes are
composed
of both electrolytes and nonelectrolytes. The body's solutes include sodium, potassium,
chloride, calcium, and magnesium.
You are caring for a 44-lb child who is hospitalized with vomiting and severe
dehydration.
The physician has ordered parenteral rehydration therapy to restore circulation. The
order
is for sodium chloride (0.9%) solution in a 20 mL/kg bolus. How much will you give? -
ANS: 400 mL
Rationale;
, 3
The child's weight must first be converted from pounds to kilograms (1 kg = 2.2 lb): 44 lb
=20 kg. Next multiply 20 kg 20 mL = 400 mL. The bolus will be 400 mL.
The nurse who provides care for young children with fluid and electrolyte imbalance
understands that they are more vulnerable to changes in fluid balance than adults.
Under normal conditions the amount of fluid ingested during the day should equal the
amount of fluid lost. Sensible water loss is that which occurs through the respiratory
tract and skin. Is this statement true or false? - ANS: F
Rationale;
Sensible water loss occurs through urine output. Insensible water loss occurs through
the
skin and respiratory tract. Insensible water loss per unit of body weight is significantly
higher in infants and young children due to the faster respiratory rate and higher
evaporative water losses.
The nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF).
Nursing care should include
a. Elevating the head but give nothing by mouth
b. Elevating the head for feedings
c. Feeding glucose water only
d. Avoiding suction unless infant is cyanotic - ANS: A
Rationale;
A When a newborn is suspected of having TEF, the most desirable position is
supine with the head elevated on an incline plane of at least 30 degrees. It is
imperative that any source of aspiration be removed at once; oral feedings are
withheld.
B Feedings should not be given to infants suspected of having TEF.
C Feedings should not be given to infants suspected of having TEF.
, 4
D The oral pharynx should be kept clear of secretion by oral suctioning. This is to
avoid cyanosis that is usually the result of laryngospasm caused by overflow of
saliva into the larynx.
A nurse is teaching a group of parents about TEF. Which statement made by the nurse
is accurate about TEF?
a. This defect results from an embryonal failure of the foregut to differentiate into
the trachea and esophagus.
b. It is a fistula between the esophagus and stomach that results in the oral intake
being refluxed and aspirated.
c. An extra connection between the esophagus and trachea develops because of
genetic abnormalities.
d. The defect occurs in the second trimester of pregnancy. -ANS: A
Rationale;
A When the foregut does not differentiate into the trachea and esophagus during
the fourth to fifth week of gestation, a TEF occurs.
B TEF is an abnormal connection between the esophagus and trachea.
C There is no connection between the trachea and esophagus in normal fetal
development.
D This defect occurs early in pregnancy during the fourth to fifth week of gestation.
What maternal assessment is related to an infant's diagnosis of TEF?
a. Maternal age more than 40 years
b. First term pregnancy for the mother
c. Maternal history of polyhydramnios
d. Complicated pregnancy - ANS: C
Rationale;
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