N4410 Exam Latest Questions with complete
solutions
What health history is looked at for children with GI issues?
-I and O
-fluid ingested (type, amt., how it was prepared)
-output (stool consistency, number of weight diapers/weight, type of emesis)
-change in appetite
How much is 1g of fluid equal to?
1mL
Physical exam GI upset
-appearance (fontanel, turgor, mucus membranes)
-level of distress (N/V/diarrhea)
-weight changes
-VS
-LOC
Why are children at high risk of fluid overload?
d/t low ADH and immature kidneys
S/S fluid overload in children
-moist breath sounds
-edema
,-bulging fontanel
-HCT levels decreased
Why are Hct levels decreased with fluid overload?
water is diluting blood
How is edema measured?
weight
Dehydration
fluid loss is greater than fluid intake
What are Hct levels with dehydration?
increased
Mild dehydration
-weight loss: 5%
-LOC: alert, restless, irritable
-skin turgor: may be normal
-urine: may be low
Treatment mild dehydration
oral fluids, can treat at home
Moderate dehydration
-weight loss: 5%-9%
,-LOC: restless, lethargic
-skin turgor: poor, low
-urine: concentrated, increased specific gravity
Treatment moderate dehydration
oral or IV fluids (100mL/kg/hr)
Severe dehydration
-weight loss: 10%
-LOC: lethargic, obtunded, comatose
-skin turgor: tenting
-urine: low auric, very increased specific gravity
Treatment severe dehydration
IV fluids (LR or isotonic fluids)
Treatment dehydration
1. correct imbalances (check electrolytes and specific gravity
2. oral fluids when possible
3. IV fluids (add K after 1st void)
4. TPN
Why do we wait to add K to IV fluids for dehydration?
we have to wait until first void to ensure kidney function is normal
, Fluid maintenance calculation
100mL: first 10kg
50mL: second 10kg
20mL: remaining kg
2/3 fluid maintenance
multiply daily maintenance by .66
1/2 fluid maintenance
multiply daily maintenance by 1.5
Shock
-circulatory failure
-complex issue characterized by inadequate/ineffective tissue perfusion
-cannot meet metabolic demands
What does shock result in?
-cellular dysfunction
-lactic acidosis
-metabolic damage
-organ failure
-death
What is the O2 demand during shock?
O2 demand is greater than O2 delivery
solutions
What health history is looked at for children with GI issues?
-I and O
-fluid ingested (type, amt., how it was prepared)
-output (stool consistency, number of weight diapers/weight, type of emesis)
-change in appetite
How much is 1g of fluid equal to?
1mL
Physical exam GI upset
-appearance (fontanel, turgor, mucus membranes)
-level of distress (N/V/diarrhea)
-weight changes
-VS
-LOC
Why are children at high risk of fluid overload?
d/t low ADH and immature kidneys
S/S fluid overload in children
-moist breath sounds
-edema
,-bulging fontanel
-HCT levels decreased
Why are Hct levels decreased with fluid overload?
water is diluting blood
How is edema measured?
weight
Dehydration
fluid loss is greater than fluid intake
What are Hct levels with dehydration?
increased
Mild dehydration
-weight loss: 5%
-LOC: alert, restless, irritable
-skin turgor: may be normal
-urine: may be low
Treatment mild dehydration
oral fluids, can treat at home
Moderate dehydration
-weight loss: 5%-9%
,-LOC: restless, lethargic
-skin turgor: poor, low
-urine: concentrated, increased specific gravity
Treatment moderate dehydration
oral or IV fluids (100mL/kg/hr)
Severe dehydration
-weight loss: 10%
-LOC: lethargic, obtunded, comatose
-skin turgor: tenting
-urine: low auric, very increased specific gravity
Treatment severe dehydration
IV fluids (LR or isotonic fluids)
Treatment dehydration
1. correct imbalances (check electrolytes and specific gravity
2. oral fluids when possible
3. IV fluids (add K after 1st void)
4. TPN
Why do we wait to add K to IV fluids for dehydration?
we have to wait until first void to ensure kidney function is normal
, Fluid maintenance calculation
100mL: first 10kg
50mL: second 10kg
20mL: remaining kg
2/3 fluid maintenance
multiply daily maintenance by .66
1/2 fluid maintenance
multiply daily maintenance by 1.5
Shock
-circulatory failure
-complex issue characterized by inadequate/ineffective tissue perfusion
-cannot meet metabolic demands
What does shock result in?
-cellular dysfunction
-lactic acidosis
-metabolic damage
-organ failure
-death
What is the O2 demand during shock?
O2 demand is greater than O2 delivery
