NUR 417 EXAM 1 2026 QUESTIONS WITH
ANSWERS GRADED A+
◉ Why are infants more at risk for dehydration than older children?
Answer: -Higher percentage of total body fluid
-Higher percentage of ECF
-Greater body surface area → higher insensible loss
-Immature kidneys
-Higher metabolic rate
-Unable to communicate thirst
-Immature gastrointestinal system
◉ How do you calculate a PO fluid bolus? Answer: - mild
dehydration (3-5%) = 50mL/kg over 4-6 hours
- moderate dehydration (6-9%) = 100mL/kg over 4-6 hours
◉ How do you calculate a IV fluid bolus? Answer: -patient cannot
take PO
-hypertonic = 10 mL/kg NS or LR
-hypotonic/isotonic = 20 mL/kg NS or LR
-Over 5-20 minutes if stable (RAPID is negative)
-Over 5-10 minutes if unstable (RAPID is positive)
,***5-10 mL/kg over 10-20 minutes if history of cardiac or renal
issues
◉ What does RAPID stand for? Answer: R = rapid heart rate
A = altered color or altered capillary refill
P = peeing nonexistent
I = inability to engage in the environment
D = decreased blood pressure
◉ How do you calculate maintenance fluid? Answer: 1st 10 kg: # of
kg x 100mL
Next 10 kg: # of kg x 50mL
Left over kg: # of kg x 20mL
This is amount over 24 hours!!
◉ How do you calculate normal urine output? Answer: Infants and
young children - 1.5 to 2mL/kg/hr
Older children and adolescents - 1mL/kg/hr
◉ What are the signs and symptoms of dehydration in pediatric
patients? Answer: -Change in LOC (irritability or lethargy)
-Decrease in skin elasticity and turgor
-Tachycardia
, -Tachypnea or Hyperpnea, Abnormal respiratory pattern
-Orthostatic Hypotension
-Sunken anterior fontanel
-Circulatory failure
-Cool dry skin, Skin mottling
-Dry mucous membranes
-Prolonged capillary refill
-Oliguria or anuria
◉ Isotonic-aka-isonatremic dehydration Answer: equal amounts of
sodium and water are lost, Sodium is wnl, results in decrease in
blood volume, hypovolemia, Fluid is lost from ECF
- causes: Illnesses of children, e.g., vomiting and diarrhea (v/d)
(gastroenteritis)
◉ Hypotonic-aka-hyponatremic dehydration Answer: too much
water or overhydration, More sodium is lost than water, More intake
of water than can be excreted, Fluid shifts from ECF to ICF in attempt
to establish normal proportions (osmotic equilibrium), Greater
water loss because the proportion of ECF volume is larger than ICF,
so physical signs are more severe then the other two types
- causes: Severe prolonged v/d, burns, renal disease, SIADH,
Drinking excessive amounts of water, Replacement with only tap
water when dehydrated
ANSWERS GRADED A+
◉ Why are infants more at risk for dehydration than older children?
Answer: -Higher percentage of total body fluid
-Higher percentage of ECF
-Greater body surface area → higher insensible loss
-Immature kidneys
-Higher metabolic rate
-Unable to communicate thirst
-Immature gastrointestinal system
◉ How do you calculate a PO fluid bolus? Answer: - mild
dehydration (3-5%) = 50mL/kg over 4-6 hours
- moderate dehydration (6-9%) = 100mL/kg over 4-6 hours
◉ How do you calculate a IV fluid bolus? Answer: -patient cannot
take PO
-hypertonic = 10 mL/kg NS or LR
-hypotonic/isotonic = 20 mL/kg NS or LR
-Over 5-20 minutes if stable (RAPID is negative)
-Over 5-10 minutes if unstable (RAPID is positive)
,***5-10 mL/kg over 10-20 minutes if history of cardiac or renal
issues
◉ What does RAPID stand for? Answer: R = rapid heart rate
A = altered color or altered capillary refill
P = peeing nonexistent
I = inability to engage in the environment
D = decreased blood pressure
◉ How do you calculate maintenance fluid? Answer: 1st 10 kg: # of
kg x 100mL
Next 10 kg: # of kg x 50mL
Left over kg: # of kg x 20mL
This is amount over 24 hours!!
◉ How do you calculate normal urine output? Answer: Infants and
young children - 1.5 to 2mL/kg/hr
Older children and adolescents - 1mL/kg/hr
◉ What are the signs and symptoms of dehydration in pediatric
patients? Answer: -Change in LOC (irritability or lethargy)
-Decrease in skin elasticity and turgor
-Tachycardia
, -Tachypnea or Hyperpnea, Abnormal respiratory pattern
-Orthostatic Hypotension
-Sunken anterior fontanel
-Circulatory failure
-Cool dry skin, Skin mottling
-Dry mucous membranes
-Prolonged capillary refill
-Oliguria or anuria
◉ Isotonic-aka-isonatremic dehydration Answer: equal amounts of
sodium and water are lost, Sodium is wnl, results in decrease in
blood volume, hypovolemia, Fluid is lost from ECF
- causes: Illnesses of children, e.g., vomiting and diarrhea (v/d)
(gastroenteritis)
◉ Hypotonic-aka-hyponatremic dehydration Answer: too much
water or overhydration, More sodium is lost than water, More intake
of water than can be excreted, Fluid shifts from ECF to ICF in attempt
to establish normal proportions (osmotic equilibrium), Greater
water loss because the proportion of ECF volume is larger than ICF,
so physical signs are more severe then the other two types
- causes: Severe prolonged v/d, burns, renal disease, SIADH,
Drinking excessive amounts of water, Replacement with only tap
water when dehydrated
