NR602/NR 602 Final Content- Week 5
Questions & Answers 100% Solved
Who is at highest risk for dehydration? - ANSWER infants and young children
Dehydration - ANSWER a common problem, increased risk of diarrhea
Body fluids make up what percent of an infants body weight? - ANSWER 75%
infants and toddlers high ratio of surface area to weight _____________________ -
ANSWER equals more body loss through evaporation
What typically causes acute diarrhea? - ANSWER viruses like rotavirus,
bacteria, and parasites
Rotavirus is common in ____________________ - ANSWER infants between 3 and
15 months of age
What can cause chronic diarrhea? - ANSWER antibiotic treatment of another
condition, poor absorption of starches and sugars, food allergies, laxative abuse
in eating disorders, hyperthyroidism, or irritable bowel syndrome
How do you treat diarrhea in acute cases? - ANSWER supportive care; includes
fluid and electrolyte replacement and/or antidiarrheals based on age
How do you treat diarrhea in chronic cases? - ANSWER treatment is specific to
the underlying condition
Assessing dehydration: HPI - ANSWER Quantity and frequency of fluid intake,
vomiting and/or diarrhea, urine output or number of wet diapers in 24 hours,
duration or degree of fever, types of medications, underlying disease
What is the most essential measure in calculating body fluid loss? - ANSWER
Weight
Assessing dehydration: physical exam - ANSWER vital signs, color, capillary
refill, skin turgor, dryness of lips and mucous membranes, lack of tears, sunken
fontanelles, output, and mental status
,Treatment of mild to moderate dehydration - ANSWER -commercially available
oral hydration solutions (ORS)
-continue breastfeeding with oral hydration solution supplementation
-offer young children 20l/kg per hour
-offer older children 100 ml of oral hydration solution every 5 minutes
-combine with IV therapy as needed
-reassess after 4 hours; repeat if needed
-avoid juice, soft drinks, and sports drinks
treatment of severe dehydration - ANSWER -evidence of compromised perfusion
and sever dehydration
-IV therapy; lactated ringers or normal saline if LR is not available
-under 1 year old, 30 ml/kg over the first hour, 70 ml/kg for the following 6 hours,
and 100 ml/kg from 6 to 24 hours
-over 1 year old, 30 ml/kg over the first 30 minutes and 70 ml/kg for the following
3 hours
-reassess every 15 to 30 minutes
mild dehydration symptoms - ANSWER 3-5% decrease in weight, normal skin
turgor, normal pulse, 2-3 cap refill, decreased tear production, mild oliguria
moderate dehydration symptoms - ANSWER 6-10% decrease in weight, slight
tenting when assessing skin turgor, slight increase in pulse, 3-4 second cap
refill
severe dehydration symptoms - ANSWER 11-15% decrease in weight, severe
tenting when assessing skin turgor, tachycardia, greater than 4 second cap
refills, tears are absent, anuria
dehydration is _____________ - ANSWER the loss of water and extracellular fluid
What terms can be used interchangeably with dehydration? - ANSWER volume
depletion or hypovolemia (loss of extracellular fluid)
Dehydration is classified as mild when ___________ - ANSWER <3% weight loss
when compared with recent current weight in older children and 5% in infants
dehydration is classified as moderate when _________ - ANSWER 6% weight loss
compared with recent current weight in older children and 10% in infants
dehydration is classified as severe when ____________ - ANSWER 9% weight loss
or greater in older children and 15% or greater in infants
Dehydration is overwhelmingly ________________ - ANSWER The result of an
infectious process, primarily viral, that often causes diarrhea
, Why are children at an increased risk for dehydration? - ANSWER higher surface
area to volume ratios, higher rate of insensible loss, and in younger children, the
inability to communicate or actively replenish losses
The vomiting history should assess the following: - ANSWER symptoms with the
onset of vomiting; duration of vomiting, quality and quantity, presence of blood
or bile, odor, precipitating event; pain; relationship of vomiting to meals,
activities, or time of day.
• Recent exposure to illness, injury, or stress; recent travel (including camping);
swimming activities; possibility of poisoning or contaminated food
• Medications currently being taken (including over-the-counter, herbal, cultural,
and homeopathic remedies)
• Presence of associated symptoms: Diarrhea, fever, ear pain, UTI symptoms,
vision changes, cough, headache, seizures, high-pitched cry, polydipsia,
polyuria, polyphagia, anorexia
• Past history of illnesses, surgeries, or hospitalizations
• Family history of GI disease or fetal or neonatal deaths (metabolic syndrome,
congenital anomaly)
vomiting early in the morning is indicative of ______________________ - ANSWER
increased intracranial pressure
What is one of the most useful clinical signs of hydration? - ANSWER capillary
refill time
Dehydration history should assess the following: - ANSWER -mental status and
thirst
-parental concern regarding decreased tearing or urination, or depressed
fontanel in infants
Dehydration physical exam - ANSWER -growth parameters and vital signs
Dehydration neurologic examination - ANSWER -nuchal rigidity, decreased level
of consciousness, and behavioral changes which can include irritability or
lethargy.
Sensorium remains intact with dehydration until ______________ - ANSWER
greater than 6% weight loss as a result of dehydration
Hypotension is a ______________ manifestation of dehydration - ANSWER late
Dehydration abdominal examination - ANSWER -inspect for distention,
abdominal scars from previous surgeries (may be associated with obstruction
and/or adhesions), or visible peristaltic waves.
-auscultate bowel sounds (i.e. increased with gastroenteritis, decreased with
obstruction, absent with ileus or peritonitis)
Questions & Answers 100% Solved
Who is at highest risk for dehydration? - ANSWER infants and young children
Dehydration - ANSWER a common problem, increased risk of diarrhea
Body fluids make up what percent of an infants body weight? - ANSWER 75%
infants and toddlers high ratio of surface area to weight _____________________ -
ANSWER equals more body loss through evaporation
What typically causes acute diarrhea? - ANSWER viruses like rotavirus,
bacteria, and parasites
Rotavirus is common in ____________________ - ANSWER infants between 3 and
15 months of age
What can cause chronic diarrhea? - ANSWER antibiotic treatment of another
condition, poor absorption of starches and sugars, food allergies, laxative abuse
in eating disorders, hyperthyroidism, or irritable bowel syndrome
How do you treat diarrhea in acute cases? - ANSWER supportive care; includes
fluid and electrolyte replacement and/or antidiarrheals based on age
How do you treat diarrhea in chronic cases? - ANSWER treatment is specific to
the underlying condition
Assessing dehydration: HPI - ANSWER Quantity and frequency of fluid intake,
vomiting and/or diarrhea, urine output or number of wet diapers in 24 hours,
duration or degree of fever, types of medications, underlying disease
What is the most essential measure in calculating body fluid loss? - ANSWER
Weight
Assessing dehydration: physical exam - ANSWER vital signs, color, capillary
refill, skin turgor, dryness of lips and mucous membranes, lack of tears, sunken
fontanelles, output, and mental status
,Treatment of mild to moderate dehydration - ANSWER -commercially available
oral hydration solutions (ORS)
-continue breastfeeding with oral hydration solution supplementation
-offer young children 20l/kg per hour
-offer older children 100 ml of oral hydration solution every 5 minutes
-combine with IV therapy as needed
-reassess after 4 hours; repeat if needed
-avoid juice, soft drinks, and sports drinks
treatment of severe dehydration - ANSWER -evidence of compromised perfusion
and sever dehydration
-IV therapy; lactated ringers or normal saline if LR is not available
-under 1 year old, 30 ml/kg over the first hour, 70 ml/kg for the following 6 hours,
and 100 ml/kg from 6 to 24 hours
-over 1 year old, 30 ml/kg over the first 30 minutes and 70 ml/kg for the following
3 hours
-reassess every 15 to 30 minutes
mild dehydration symptoms - ANSWER 3-5% decrease in weight, normal skin
turgor, normal pulse, 2-3 cap refill, decreased tear production, mild oliguria
moderate dehydration symptoms - ANSWER 6-10% decrease in weight, slight
tenting when assessing skin turgor, slight increase in pulse, 3-4 second cap
refill
severe dehydration symptoms - ANSWER 11-15% decrease in weight, severe
tenting when assessing skin turgor, tachycardia, greater than 4 second cap
refills, tears are absent, anuria
dehydration is _____________ - ANSWER the loss of water and extracellular fluid
What terms can be used interchangeably with dehydration? - ANSWER volume
depletion or hypovolemia (loss of extracellular fluid)
Dehydration is classified as mild when ___________ - ANSWER <3% weight loss
when compared with recent current weight in older children and 5% in infants
dehydration is classified as moderate when _________ - ANSWER 6% weight loss
compared with recent current weight in older children and 10% in infants
dehydration is classified as severe when ____________ - ANSWER 9% weight loss
or greater in older children and 15% or greater in infants
Dehydration is overwhelmingly ________________ - ANSWER The result of an
infectious process, primarily viral, that often causes diarrhea
, Why are children at an increased risk for dehydration? - ANSWER higher surface
area to volume ratios, higher rate of insensible loss, and in younger children, the
inability to communicate or actively replenish losses
The vomiting history should assess the following: - ANSWER symptoms with the
onset of vomiting; duration of vomiting, quality and quantity, presence of blood
or bile, odor, precipitating event; pain; relationship of vomiting to meals,
activities, or time of day.
• Recent exposure to illness, injury, or stress; recent travel (including camping);
swimming activities; possibility of poisoning or contaminated food
• Medications currently being taken (including over-the-counter, herbal, cultural,
and homeopathic remedies)
• Presence of associated symptoms: Diarrhea, fever, ear pain, UTI symptoms,
vision changes, cough, headache, seizures, high-pitched cry, polydipsia,
polyuria, polyphagia, anorexia
• Past history of illnesses, surgeries, or hospitalizations
• Family history of GI disease or fetal or neonatal deaths (metabolic syndrome,
congenital anomaly)
vomiting early in the morning is indicative of ______________________ - ANSWER
increased intracranial pressure
What is one of the most useful clinical signs of hydration? - ANSWER capillary
refill time
Dehydration history should assess the following: - ANSWER -mental status and
thirst
-parental concern regarding decreased tearing or urination, or depressed
fontanel in infants
Dehydration physical exam - ANSWER -growth parameters and vital signs
Dehydration neurologic examination - ANSWER -nuchal rigidity, decreased level
of consciousness, and behavioral changes which can include irritability or
lethargy.
Sensorium remains intact with dehydration until ______________ - ANSWER
greater than 6% weight loss as a result of dehydration
Hypotension is a ______________ manifestation of dehydration - ANSWER late
Dehydration abdominal examination - ANSWER -inspect for distention,
abdominal scars from previous surgeries (may be associated with obstruction
and/or adhesions), or visible peristaltic waves.
-auscultate bowel sounds (i.e. increased with gastroenteritis, decreased with
obstruction, absent with ileus or peritonitis)
