NR 602 FINAL EXAM: WEEK 5 CONCEPTS EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 602 FINAL EXAM: WEEK 5 CONCEPTS EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. What is dehydration Correct Answer The loss of water and extracellular fluid. 2. What is another term for dehydration Correct Answer Hypovolemia or volume depletion. 3. How is dehydration classified in older children Correct Answer Mild 3% weight loss Moderate 6% weight loss Severe 9% weight loss 4. How is dehydration classified in infants Correct Answer Mild 5% weight loss Moderate 10% Severe 15% 5. Dehydration is overwhelmingly the result of an infectious process that causes what Correct Answer Diarrhea 6. Why are children at increased risk for dehydration Correct Answer Higher surface-area to volume ratios, higher rate of insensible loss, or inability to communicate or replenish loss. 7. Depending on the cause of dehydration, what may be lost Correct Answer Water and salt. 8. What are the three types of dehydration Correct Answer isonatremic, hyponatremic, hypernatremic 9. When dehydration is caused by simple diarrhea, what type of dehydration is it Correct Answer Isonatremia 10. When vomiting occurs with diarrhea and water intake is decreased, what type of dehydration occurs Correct Answer Hypernatremic 11. When there is massive stool loss of water AND salt and only water is ingested, what type of dehydration does it cause Correct Answer Hyponatremia 12. What should be asked in the patient history if they have dehydration Correct Answer Ask about vomiting and its causes, associated pain, activities, presence of bile or blood, precipitating event, recent sick contact, medications, presence of other illness. 13. The dehydration history should assess the following:: Mental status and thirst, signs of dehydration like decreased tearing, urination, or depressed fontanel in infants. 14. Sensorium (awareness) remains intact until there is greater than ____% weight loss as a result of dehydration Correct Answer 6 15. What is a late manifestation of dehydration Correct Answer Hypotension. 16. The neurological exam for dehydration includes what Correct Answer Nuchal rigidity, change in LOC, behavioral change such as lethargy or irritability. 17. The abdominal exam for dehydration includes what Correct Answer Inspect for distention, scars, peristaltic waves, bowel sounds, palpation. 18. What respiratory manifestations may be a result of dehydration Correct Answer Tachypnea, decreased O2, stridor 19. What signs are most helpful in determining dehydration? What is the most useful Correct Answer Capillary refill (CRT) is most useful; Should be less than 2 seconds. CRT, skin turgor, and tachypnea together are most helpful in determining dehydration. 20. What are the 4 components of the clinical dehydration scale and what is it for Correct Answer Predictive tool regarding length of stay and need for IV fluids. Parameters are appearance, sunken eyes, moisture of mucous membrane and presence of tears. 21. What diagnostic studies are performed for dehydration Correct Answer CBC, BC, CMP (including BUN/Cr) LFTs Glucose Serum sodium CRP ESR Lactate Ammonia UA/UC Tox Stool Rapid strep/throat culture Pregnancy Test 22. How does minimal or no dehydration present (3%) Correct Answer [PATIENT PRESENTS NORMAL, MAY HAVE DECREASED URINE OUTPUT] Patient is well, alert. Drinks normally or may refuse liquids. HR, pulse, breathing, eyes, tears normal. Mouth moist, good turgor, normal cap refill, warm extremities. Urine output may be normal to decreased. 23. How does mild to moderate dehydration present (3%-9%) Correct Answer [PATIENT MAY PRESENT NORMAL OR WITH MILD SIGNS OF DEHYDRATION] Mental status is normal, may be fatigued, restless or irritable. They will be thirsty or eager to drink. HR may be normal increased. Breathing may be normal-fast. Eyes slightly sunken and tears decreased. Mouth and tongue may be dry and skin may recoil in less than 2 seconds. Cap refill will be prolonged. Extremities may be cool and urine output may be decreased. 24. How does severe dehydration present (9%) Correct Answer [PATIENT IS LETHARGIC, VS POOR, DRY APPEARING] Patient may be lethargic or unconscious, drinking poorly or unable to drink. Patient may be tachy or Brady if severe. Pulse weak and thready. Eyes will be sunken in and no tears. Mouth and tongue will be parched. Skin turgor poor 2s. Capillary refill will be prolonged or minimal. Extremities will be cold and no or little urine output. 25. What imaging may be needed for a patient with dehydration Correct Answer KUB, CXR, US, Barium swallow or enema, CT, MRI, Endoscopy 26. If dehydration is caused by vomiting, what is the plan of care Correct Answer Identify and alleviate cause. Zofran may be used. Refer if vomiting persistent. 27. How is dehydration treated Correct Answer Determine degree of dehydration. Minimal, mild, or moderate: ORS with 70-90 mEq/L sodium, 25 g/L glucose, 20 mEq/L potassium, 30 mEq/L base with a defined osmolarity of 240 to 300 mOsm/L. Severe: IV fluids. 28. What can aid absorption of subcutaneous fluids and reduce risk of allergic reaction Correct Answer Human Hyaluronidase 29. What is the maintenance therapy for dehydration by weight Correct Answer 0-10kg: 100mL/kg/24hr 10-20kg: 1000mL + 50mL/kg for each kg over 10 20kg: 1500mL+ 20mL/kg or each kg over 20 30. What is the replacement therapy for dehydration by weight Correct Answer 10 kg: 60-120 mL ORS for each diarrhea or vomiting episode 10kg: 120-240 mL ORS for each diarrhea or vomiting episode For severe dehydration if child is unable to drink administer via NGT. 31. What is the rehydration therapy for moderate dehydration Correct Answer ORS: 50-100 mL/kg body weight over 3-4 hours 32. What is the rehydration therapy for severe dehydration Correct Answer LR or NS IV in blouses of 20mL/kg until mental status improves. If no improvement shock should be considered. 33. Does minimal dehydration require rehydration therapy Correct Answer No. 34. What advice should be given to parents of a dehydrated child Correct Answer Continue breast- feeding. Lactose-containing formulas are usually well tolerated. Return to regular milk in smaller amounts more often. Result age appropriate diet after rehydration. Complex carbs, fruits, lean meat, yogurt and veggies are recommended. Avoid fatty foods or simple sugars. Avoid soda and juice. 35. What is colic Correct Answer Colic is defined as crying for no apparent reason that lasts for 3 hours or more per day, 3 days per week in a healthy infant younger than 3 months..