Pediatric HESI Case Study Fluid and Electrolytes Test Questions and Answers
The parents of a term newborn express concern because
their own parents live in another city and they are not
available to help with their newborn. The infant's family
Section 1 chooses to formula feed and is given a 2-week supply of
formula when discharged from the Newborn Nursery. The
nurse provides client education related to the nutrition
and fluid needs of infants.
What are the principles of fluid balance?
A. Infants have a greater percent of fluid in the extracellu-
lar compartment compared to adults therefore, they have
greater and more rapid fluid losses.
B. Due to their small size, infants have a smaller body sur- Infants have a greater percent of fluid in the extracellular
face area for loss of insensible fluid compared to adults. compartment compared to adults; therefore, they have
C. Because infants have a greater body surface area greater and more rapid fluid losses
than adults, they have a higher basal metabolic rate than
adults.
D. An infant's kidney concentrates and dilutes solute efl-
ciently at birth.
The infant now weighs 3.4 kg. Referencing the fluid com-
position chart, what is the infant's daily maintenance fluid
requirement? (Enter numerical value only. If rounding is
necessary, round to the nearest whole number.)
340
Body Weight
3.4 kg x 100 mL/kg = 340 mL. After the neonatal peri-
1 to 10 kg
od, infants weighing 1 to 10 kg require 100 mL/kg of
11 to 20 kg
maintenance fluids per day. Fluid losses such as vomiting,
>20kg
diarrhea, or fever are added to this calculation.
Amount of Fluid Per Day
100 mL/kg
1000mL plus 50mL/kg for each kg>10kg
1500 mL plus 20mL/kg for each kg >20kg
Section 2
, Safe and Ettective Care: Management of CareAt 3-weeks
of age, the caregiver brings their infant to the clinic with
signs of "increased sleepiness and decreased interac-
tion." A detailed history reveals the family is diluting the
formula every day in an attempt to make the formula last
longer, due to limited financial resources. The family is also
supplementing feedings with plain water.
The nurse suspects the infant may be experiencing wa-
ter intoxication. Which findings confirm this assessment? Irritability (Lethargy or irritability characterize water intox-
(Select all that apply. One, some, or all options may be ication.)
correct.)
Specific Gravity of 1.005 (Low specific gravity indicates
A. Weak, slow pulse
diulte urine and is associated with water intoxication.)
B. Irritability
C. Specific gravity of 1.005. Moist Rales Bilaterally (Moist rales will be heard due to
D. Moist rales bilaterally fluid excess.)
E. Sodium level of 140 mEq/L (140 mmol/L)
The infant is admitted to the NICU and the healthcare
provider (HCP) prescribes diuretics. Which is a priority
nursing intervention?
A. Monitor vital signs every 4 hours. implement seizures precautions (Fluid and electrolyte im-
B. Implement seizure precautions. balances can cause seizures.)
C. Insert a urinary catheter for accurate measurement of
intake & output.
D. Postpone neurologic assessments until admission is
complete.
The healthcare provider (HCP) prescribes Furosemide 2
mg/kg PO as a one time dose. Medication available: 0.68
FUROSEMIDE ORAL SOLUTION USP, 10 mg/mL. Based on
the neonate's weight of 3.4 kg, what is the correct amount 3.4kg *2mg/kg = 6.8mg. Dose ordered [6.8mg] divided
of medication to be administered? (Enter numerical value
The parents of a term newborn express concern because
their own parents live in another city and they are not
available to help with their newborn. The infant's family
Section 1 chooses to formula feed and is given a 2-week supply of
formula when discharged from the Newborn Nursery. The
nurse provides client education related to the nutrition
and fluid needs of infants.
What are the principles of fluid balance?
A. Infants have a greater percent of fluid in the extracellu-
lar compartment compared to adults therefore, they have
greater and more rapid fluid losses.
B. Due to their small size, infants have a smaller body sur- Infants have a greater percent of fluid in the extracellular
face area for loss of insensible fluid compared to adults. compartment compared to adults; therefore, they have
C. Because infants have a greater body surface area greater and more rapid fluid losses
than adults, they have a higher basal metabolic rate than
adults.
D. An infant's kidney concentrates and dilutes solute efl-
ciently at birth.
The infant now weighs 3.4 kg. Referencing the fluid com-
position chart, what is the infant's daily maintenance fluid
requirement? (Enter numerical value only. If rounding is
necessary, round to the nearest whole number.)
340
Body Weight
3.4 kg x 100 mL/kg = 340 mL. After the neonatal peri-
1 to 10 kg
od, infants weighing 1 to 10 kg require 100 mL/kg of
11 to 20 kg
maintenance fluids per day. Fluid losses such as vomiting,
>20kg
diarrhea, or fever are added to this calculation.
Amount of Fluid Per Day
100 mL/kg
1000mL plus 50mL/kg for each kg>10kg
1500 mL plus 20mL/kg for each kg >20kg
Section 2
, Safe and Ettective Care: Management of CareAt 3-weeks
of age, the caregiver brings their infant to the clinic with
signs of "increased sleepiness and decreased interac-
tion." A detailed history reveals the family is diluting the
formula every day in an attempt to make the formula last
longer, due to limited financial resources. The family is also
supplementing feedings with plain water.
The nurse suspects the infant may be experiencing wa-
ter intoxication. Which findings confirm this assessment? Irritability (Lethargy or irritability characterize water intox-
(Select all that apply. One, some, or all options may be ication.)
correct.)
Specific Gravity of 1.005 (Low specific gravity indicates
A. Weak, slow pulse
diulte urine and is associated with water intoxication.)
B. Irritability
C. Specific gravity of 1.005. Moist Rales Bilaterally (Moist rales will be heard due to
D. Moist rales bilaterally fluid excess.)
E. Sodium level of 140 mEq/L (140 mmol/L)
The infant is admitted to the NICU and the healthcare
provider (HCP) prescribes diuretics. Which is a priority
nursing intervention?
A. Monitor vital signs every 4 hours. implement seizures precautions (Fluid and electrolyte im-
B. Implement seizure precautions. balances can cause seizures.)
C. Insert a urinary catheter for accurate measurement of
intake & output.
D. Postpone neurologic assessments until admission is
complete.
The healthcare provider (HCP) prescribes Furosemide 2
mg/kg PO as a one time dose. Medication available: 0.68
FUROSEMIDE ORAL SOLUTION USP, 10 mg/mL. Based on
the neonate's weight of 3.4 kg, what is the correct amount 3.4kg *2mg/kg = 6.8mg. Dose ordered [6.8mg] divided
of medication to be administered? (Enter numerical value
