NURS 364 - EXAM 2 QUESTIONS AND ACCURATE ANSWERS
Expected urinary output for infants up to the age of 1 year is.
2 mL/kg/hr
What is the correct positioning when instilling ear drops for infants and young children
younger than age 4?
pull the auricle down and back
The most reliable indicator of fluid loss in infants and children is
Weight
Ibuprofen is contraindicated in infants until the child reaches.
6 months
Isotonic dehydration
WATER LOSS = ELECTROLYTE LOSS aka Hypovolemia
Results: decreased circulating blood volume and inadequate tissue perfusion
MOST COMMON TYPE of dehydration!!!!!!!!!!!
What is the biggest threat to life w/ isotonic dehydration?
Shock
Hypotonic dehydration
ELECTROLYTE LOSS > water loss
,Results: fluid shifts between compartments causing a decrease in plasma volume and
the cells to SWELL and further decrease in ECF
Plasma sodium level in hypotonic dehydration
<130 mEq/L
Hypertonic dehydration
WATER LOSS exceeds electrolyte loss; change in the concentration of specific plasma
electrolytes
Results: fluid shifted from the intracellular compartment into the plasma and interstitial
fluid compartments resulting in cellular dehydration and SHRINKAGE; most dangerous
type
Sodium plasma level in hypertonic dehydration
>150 mEq/L
Clinical manifestations of severe dehydration
Weight loss (%): ≥ 10
Behavior: normal to lethargic or comatose
Thirst: intense
Mucous membranes: dry
Anterior fontanelle: sunken
Eyes: deeply sunken
,Skin turgor: decreased
BP: normal to decreased
HR: increased
Urine output: anuria
Tx for severe dehyration
Rehydration therapy: IV fluids (LR), 40 ml/kg until pulse and state of consciousness
return to normal; then 50-100 mL/kg or ORS
Hirschsprung's Disease
aka aganglionic megacolon:
- Lack of ganglion cells in affected areas in intestine -> loss of rectosphincteric reflex
and an abnormal microenvironment of the cells
- Results in congenital aganglionic megacolon
- Decreased ability of internal sphincter relaxation
Clinical manifestations of Hirschsprung's Disease - Newborn period
, Failure to void meconium within 24 - 48 hrs after birth
Refusal to feed
Bilious vomiting
Abdominal distention
Clinical manifestations of Hirschsprung's Disease - Infant
FTT
Constipation
Abdominal distention
Episodes of diarrhea (explosive, water) and vomiting
Fever
Appears significantly ill
Clinical manifestations of Hirschsprung's Disease - Childhood
Expected urinary output for infants up to the age of 1 year is.
2 mL/kg/hr
What is the correct positioning when instilling ear drops for infants and young children
younger than age 4?
pull the auricle down and back
The most reliable indicator of fluid loss in infants and children is
Weight
Ibuprofen is contraindicated in infants until the child reaches.
6 months
Isotonic dehydration
WATER LOSS = ELECTROLYTE LOSS aka Hypovolemia
Results: decreased circulating blood volume and inadequate tissue perfusion
MOST COMMON TYPE of dehydration!!!!!!!!!!!
What is the biggest threat to life w/ isotonic dehydration?
Shock
Hypotonic dehydration
ELECTROLYTE LOSS > water loss
,Results: fluid shifts between compartments causing a decrease in plasma volume and
the cells to SWELL and further decrease in ECF
Plasma sodium level in hypotonic dehydration
<130 mEq/L
Hypertonic dehydration
WATER LOSS exceeds electrolyte loss; change in the concentration of specific plasma
electrolytes
Results: fluid shifted from the intracellular compartment into the plasma and interstitial
fluid compartments resulting in cellular dehydration and SHRINKAGE; most dangerous
type
Sodium plasma level in hypertonic dehydration
>150 mEq/L
Clinical manifestations of severe dehydration
Weight loss (%): ≥ 10
Behavior: normal to lethargic or comatose
Thirst: intense
Mucous membranes: dry
Anterior fontanelle: sunken
Eyes: deeply sunken
,Skin turgor: decreased
BP: normal to decreased
HR: increased
Urine output: anuria
Tx for severe dehyration
Rehydration therapy: IV fluids (LR), 40 ml/kg until pulse and state of consciousness
return to normal; then 50-100 mL/kg or ORS
Hirschsprung's Disease
aka aganglionic megacolon:
- Lack of ganglion cells in affected areas in intestine -> loss of rectosphincteric reflex
and an abnormal microenvironment of the cells
- Results in congenital aganglionic megacolon
- Decreased ability of internal sphincter relaxation
Clinical manifestations of Hirschsprung's Disease - Newborn period
, Failure to void meconium within 24 - 48 hrs after birth
Refusal to feed
Bilious vomiting
Abdominal distention
Clinical manifestations of Hirschsprung's Disease - Infant
FTT
Constipation
Abdominal distention
Episodes of diarrhea (explosive, water) and vomiting
Fever
Appears significantly ill
Clinical manifestations of Hirschsprung's Disease - Childhood
