Pediatric Hesi Case Study: Dehydration
After 3 hours, the infant still has no urine output. The healthcare provider (HCP) prescribes an
in-and-out catheterization to obtain a urine specimen. The nurse explains the procedure to the
caregiver who begins to cry, stating the healthcare team is causing the child harm.
What is the BEST response by the nurse?
A. I will ask the HCP if the urine bag can remain a few hours longer
B. "I will let the HCP know you are refusing the procedure since you have that right as his
caregiver."
C. This procedure is important to make the best medical decisions for the infant. It may be
uncomfortable but it will not cause any long term effects
D. "Please wait outside until the procedure is finished." - ANS-Answer (s): C
Rational:
This is honestly just common sense
Based on the 2012 safety alert issued by the Child Health Patient Safety Organization, which
method for NGT placement verification is no longer recommended?
A. pH testing
B. X-ray
C. Aspiration
D. Auscultation - ANS-Answer (s): D
Rational:
This is a subjective method, and the nurse should rely on objective methods.
Based on the nurse's knowledge of growth and development, which is the best play intervention
for a 7-month-old?
A. Colored blocks
B. Bright dangling mobile
C. Ball
, D. Stuffed animal - ANS-Answer (s): A
Rational:
At 7-months-old, the infant should have fine motor skills to grasp, hold, and manipulate objects,
transfer objects from hand to hand, bang objects together, and release objects. He should be
able to imitate actions and noises. Colored blocks provide the ability to use gross motor skills.
Following the administration of the client's vaccinations, the nurse continues to educate the
family regarding safety measures. Which safety measures should the nurse teach the family?
A. Freely sprinkle baby powder on skin after bathing to keep the skin moist.
B. Offer a bottle of juice at bedtime to keep the child full during the night.
C. Position on the right side or the left side for napping.
D. Place in the backseat in a rear-facing car seat when traveling. - ANS-Answer (s): D.
Rational:
Infants who are 7-months-old should be rear-facing. Car seats are approved based on weight
and height; however, the American Academy of Pediatrics recommends that all children remain
rear-facing until at least 2-years-old.
Infant formula is 20 kcal per oz and the infant consumes 4 oz every 4 hrs. How many kcal per
day is the infant consuming>? - ANS-Answer (s): 480 kcal
Rational:
- 24 hrs / 4 hrs = 6 feeds per day
- 4oz x 6 = 24 oz of total formula consumed in a day
- 24 oz x 20 = 480 kcal
Lab Values
- 137 meq/L (mmol/L)
Based on the client's lab values, which type of dehydration does the nurse suspect?
A. Isonatremic
B. Hyponatremic
C. Hypernatremic
D. Hypokalemic - ANS-Answer (s): A
Rational:
After 3 hours, the infant still has no urine output. The healthcare provider (HCP) prescribes an
in-and-out catheterization to obtain a urine specimen. The nurse explains the procedure to the
caregiver who begins to cry, stating the healthcare team is causing the child harm.
What is the BEST response by the nurse?
A. I will ask the HCP if the urine bag can remain a few hours longer
B. "I will let the HCP know you are refusing the procedure since you have that right as his
caregiver."
C. This procedure is important to make the best medical decisions for the infant. It may be
uncomfortable but it will not cause any long term effects
D. "Please wait outside until the procedure is finished." - ANS-Answer (s): C
Rational:
This is honestly just common sense
Based on the 2012 safety alert issued by the Child Health Patient Safety Organization, which
method for NGT placement verification is no longer recommended?
A. pH testing
B. X-ray
C. Aspiration
D. Auscultation - ANS-Answer (s): D
Rational:
This is a subjective method, and the nurse should rely on objective methods.
Based on the nurse's knowledge of growth and development, which is the best play intervention
for a 7-month-old?
A. Colored blocks
B. Bright dangling mobile
C. Ball
, D. Stuffed animal - ANS-Answer (s): A
Rational:
At 7-months-old, the infant should have fine motor skills to grasp, hold, and manipulate objects,
transfer objects from hand to hand, bang objects together, and release objects. He should be
able to imitate actions and noises. Colored blocks provide the ability to use gross motor skills.
Following the administration of the client's vaccinations, the nurse continues to educate the
family regarding safety measures. Which safety measures should the nurse teach the family?
A. Freely sprinkle baby powder on skin after bathing to keep the skin moist.
B. Offer a bottle of juice at bedtime to keep the child full during the night.
C. Position on the right side or the left side for napping.
D. Place in the backseat in a rear-facing car seat when traveling. - ANS-Answer (s): D.
Rational:
Infants who are 7-months-old should be rear-facing. Car seats are approved based on weight
and height; however, the American Academy of Pediatrics recommends that all children remain
rear-facing until at least 2-years-old.
Infant formula is 20 kcal per oz and the infant consumes 4 oz every 4 hrs. How many kcal per
day is the infant consuming>? - ANS-Answer (s): 480 kcal
Rational:
- 24 hrs / 4 hrs = 6 feeds per day
- 4oz x 6 = 24 oz of total formula consumed in a day
- 24 oz x 20 = 480 kcal
Lab Values
- 137 meq/L (mmol/L)
Based on the client's lab values, which type of dehydration does the nurse suspect?
A. Isonatremic
B. Hyponatremic
C. Hypernatremic
D. Hypokalemic - ANS-Answer (s): A
Rational:
