Scribd Logo
Upload

Welcome to Scribd!

  • 290 views

    Case Study-Infant With Fluid Imbalance08-10-KEY

    Uploaded by

    reecole
    An 11 kg, 1-year-old child is admitted with 1 kg weight loss. The child's 24-hour fluid needs are calculated to be 2,150 mL based on maintenance needs of 1,050 mL and replacement needs of 1,100 mL for 10% dehydration. The fluid is spaced with 1,075 mL in the first 8 hours and 1,075 mL over the next 16 hours. Vomiting continues so weight monitoring is important to assess further fluid loss. A subsequent 0.5 kg weight loss equals a fluid deficit of 500 mL and percentage weight loss of 3%.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Case Study-Infant With Fluid Imbalance08-10-KEY

    Uploaded by

    reecole
    290 views3 pages
    An 11 kg, 1-year-old child is admitted with 1 kg weight loss. The child's 24-hour fluid needs are calculated to be 2,150 mL based on maintenance needs of 1,050 mL and replacement needs of 1,100 mL for 10% dehydration. The fluid is spaced with 1,075 mL in the first 8 hours and 1,075 mL over the next 16 hours. Vomiting continues so weight monitoring is important to assess further fluid loss. A subsequent 0.5 kg weight loss equals a fluid deficit of 500 mL and percentage weight loss of 3%.

    Original Title

    Case Study-Infant with Fluid Imbalance08-10-KEY

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    An 11 kg, 1-year-old child is admitted with 1 kg weight loss. The child's 24-hour fluid needs are calculated to be 2,150 mL based on maintenance needs of 1,050 mL and replacement needs of 1,100 mL for 10% dehydration. The fluid is spaced with 1,075 mL in the first 8 hours and 1,075 mL over the next 16 hours. Vomiting continues so weight monitoring is important to assess further fluid loss. A subsequent 0.5 kg weight loss equals a fluid deficit of 500 mL and percentage weight loss of 3%.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    290 views3 pages

    Case Study-Infant With Fluid Imbalance08-10-KEY

    Uploaded by

    reecole
    An 11 kg, 1-year-old child is admitted with 1 kg weight loss. The child's 24-hour fluid needs are calculated to be 2,150 mL based on maintenance needs of 1,050 mL and replacement needs of 1,100 mL for 10% dehydration. The fluid is spaced with 1,075 mL in the first 8 hours and 1,075 mL over the next 16 hours. Vomiting continues so weight monitoring is important to assess further fluid loss. A subsequent 0.5 kg weight loss equals a fluid deficit of 500 mL and percentage weight loss of 3%.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3

    Case Study-Infant with Fluid Imbalance

    An 11 kg (24.2 lb) 1-year-old child is admitted with a


    weight loss of 1 kg.

    1. Calculate the child's 24-hour fluid needs based on


    maintenance fluid need for her weight and replacement fluid
    need for her degree of dehydration.

    Maintenance fluid is calculated as follows:


    100 mL of fluid per 10 kg of body weight = 1,000 mL PLUS 50 mL of fluid per 1 kg of
    body weight = 50 mL. So, total maintenance fluid requirement is 1,050 mL/24 hour.
    To calculate the amount of replacement fluid required for the degree of diarrhea, the
    percentage of body weight lost needs to be calculated: 1 kg is approximately 10% of
    the total weight of 11 kg; therefore, 10 × 10 = 100 mL/kg/24 hours. The replacement
    need is 100 mL × 11 kg = 1,100 mL/24 hour. The maintenance fluid requirement
    plus the replacement fluid need is 2,150 mL/24 hours.

    2. Once you have calculated the 24-hour fluid needs, space it


    over the day as you would expect it to be administered.

    About one-half of the 24-hour total usually is given in the first 6 to 8 hours, and then
    the rate is adjusted to administer the remainder in the rest of the 24-hour period.
    The first half—1,075 mL—will be given over 8 hours at 134 mL/hour. The remaining
    1,075 mL will be administered over 16 hours at 67 mL/hour.

    3. The child continues to vomit. How will those replacement


    needs alter the amount of required fluid intake for the child?

    Weight is the best indicator for fluid balance. All diapers, clothes, or bedding that
    contains vomit can be weighed. Additionally, the child's weight reflects additional
    fluid loss and should be monitored closely.

    4. If the child has lost 0.5 kg from the former weight, what is
    the amount of fluid deficit?

    In the metric system, 1 mg equals 1 mL. A kilogram equals 1,000 mL. Therefore, 0.5
    kg equals 500 mL.

    5. If the infant's weight originally was 15 kg and now is 14.5


    kg, what is the percentage of weight loss?

    The weight loss is 0.5 kg. The question is what percent of 15 kg is 0.5 kg, so 0.5 kg ÷
    15 kg yields a 3% weight loss.
    NCLEX Questions

    1. A 6-month-old infant is admitted with severe


    dehydration. Effectiveness of therapy is evaluated with
    which of the following assessment measures? Select all
    that apply.

    1. Record intake and output accurately


    2. Daily weights on the same scale, same time, with no
    clothes
    3. Evaluate level of consciousness continuously
    4. Document mucous membrane moisture every shift
    5. Document abdominal girth every shift

    Rationale: All of the choices represent assessment measures that evaluate the
    effectiveness of therapy except abdominal girth, which does not provide information
    regarding hydration status.

    2. Arterial blood gases results indicate pH 7.33 and PCO2


    of 38 mmHg following arrest and subsequent
    resuscitation of a 3-year-old child. Which nursing
    intervention should be utilized to attempt to correct this
    metabolic disorder?

    1. Determine if the endotracheal tube is positioned correctly


    2. Administer sodium bicarbonate 1 mEq/kg IV
    3. Assess the effectiveness of the respiratory pattern
    4. Treat the cause of the acidosis
    Rationale: Sodium bicarbonate is used to correct serious metabolic acidosis. Metabolic acidosis
    is present, but sodium bicarbonate is given only in serious imbalance. We do not have enough
    information to determine if that is the case. The medication often complicates acid-base
    imbalance. Airway always is important to assess, but the PCO2 level indicates that respirations
    are not contributing to the problem. The best answer is to find and treat the cause of the
    acidosis.

    3. The nurse notes the following changes in the past 24


    hours in a child with heart failure. Which finding is the
    most significant in assessing the child for fluid volume
    overload?

    1. Weight gain of .4 kg
    2. Jugular venous distention
    3. Presence of lung crackles
    4. Bounding pulse

    Rationale: All are signs of fluid volume overload. However, an increase of weight is
    always the best indicator of an increase in fluid. The other options indicate heart
    failure as a result of the increase fluid.

    You might also like