What factor predisposes an infant to fluid imbalances?
a.
Decreased surface area
b.
Lower metabolic rate
c.
Immature kidney functioning
d.
Decreased daily exchange of extracellular fluid - ANSWER ANS: C
The infant's kidneys are functionally immature at birth and are inefficient in
excreting waste products of metabolism. Infants have a relatively high body
surface area (BSA) compared with adults. This allows a higher loss of fluid to
the environment. A higher metabolic rate is present as a result of the higher
BSA with active metabolic tissue. The higher metabolic rate increases heat
production, which results in greater insensible water loss. Infants have a greater
exchange of extracellular fluid, leaving them with a reduced fluid reserve in
conditions of dehydration.
What is the required number of milliliters of fluid needed per day for a 14 kg
child?
a.
800
,b.
1000
c.
1200
d.
1400 - ANSWER ANS: C
For the first 10 kg of body weight, a child requires 100 mL/kg. For each
additional kilogram of body weight, an extra 50 mL is needed.
10 kg ´ 100 mL/kg/day = 1000 mL
4 kg ´ 50 mL/kg/day = 200 mL
1000 mL + 200 mL = 1200 ml/day
800 to 1000 mL is too little; 1400 mL is too much.
An infant is brought to the emergency department with the following clinical
manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and
tachypnea. This is suggestive of which situation?
a.
Water excess
b.
Sodium excess
c.
Water depletion
d.
Potassium excess - ANSWER ANS: C
These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess or overhydration. Sodium or potassium
excess would not cause these symptoms.
, What laboratory finding should the nurse expect in a child with an excess of
water?
a.
Decreased hematocrit
b.
High serum osmolality
c.
High urine specific gravity
d.
Increased blood urea nitrogen - ANSWER ANS: A
The excess water in the circulatory system results in hemodilution. The
laboratory results show a falsely decreased hematocrit. Laboratory analysis of
blood that is hemodiluted reveals decreased serum osmolality and blood urea
nitrogen. The urine specific gravity is variable relative to the child's ability to
correct the fluid imbalance.
Physiologically, the child compensates for fluid volume losses by which
mechanism?
a.
Inhibition of aldosterone secretion
b.
Hemoconcentration to reduce cardiac workload
c.
Fluid shift from interstitial space to intravascular space
d.
Vasodilation of peripheral arterioles to increase perfusion - ANSWER ANS: C
a.
Decreased surface area
b.
Lower metabolic rate
c.
Immature kidney functioning
d.
Decreased daily exchange of extracellular fluid - ANSWER ANS: C
The infant's kidneys are functionally immature at birth and are inefficient in
excreting waste products of metabolism. Infants have a relatively high body
surface area (BSA) compared with adults. This allows a higher loss of fluid to
the environment. A higher metabolic rate is present as a result of the higher
BSA with active metabolic tissue. The higher metabolic rate increases heat
production, which results in greater insensible water loss. Infants have a greater
exchange of extracellular fluid, leaving them with a reduced fluid reserve in
conditions of dehydration.
What is the required number of milliliters of fluid needed per day for a 14 kg
child?
a.
800
,b.
1000
c.
1200
d.
1400 - ANSWER ANS: C
For the first 10 kg of body weight, a child requires 100 mL/kg. For each
additional kilogram of body weight, an extra 50 mL is needed.
10 kg ´ 100 mL/kg/day = 1000 mL
4 kg ´ 50 mL/kg/day = 200 mL
1000 mL + 200 mL = 1200 ml/day
800 to 1000 mL is too little; 1400 mL is too much.
An infant is brought to the emergency department with the following clinical
manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and
tachypnea. This is suggestive of which situation?
a.
Water excess
b.
Sodium excess
c.
Water depletion
d.
Potassium excess - ANSWER ANS: C
These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess or overhydration. Sodium or potassium
excess would not cause these symptoms.
, What laboratory finding should the nurse expect in a child with an excess of
water?
a.
Decreased hematocrit
b.
High serum osmolality
c.
High urine specific gravity
d.
Increased blood urea nitrogen - ANSWER ANS: A
The excess water in the circulatory system results in hemodilution. The
laboratory results show a falsely decreased hematocrit. Laboratory analysis of
blood that is hemodiluted reveals decreased serum osmolality and blood urea
nitrogen. The urine specific gravity is variable relative to the child's ability to
correct the fluid imbalance.
Physiologically, the child compensates for fluid volume losses by which
mechanism?
a.
Inhibition of aldosterone secretion
b.
Hemoconcentration to reduce cardiac workload
c.
Fluid shift from interstitial space to intravascular space
d.
Vasodilation of peripheral arterioles to increase perfusion - ANSWER ANS: C
