Chapter 40
Understanding Pediatric Acid-Base Balance
This quiz is designed to test and enhance your knowledge of pediatric acid-base balance and hydration management. It covers various aspects of electrolyte imbalances, dehydration in infants, and the appropriate nursing interventions.
Key features of the quiz include:
- Multiple-choice questions
- Real-life scenarios
- Critical thinking opportunities
The parents of a child with acid-base imbalance ask the nurse about mechanisms that regulate acid-base balance. Which statement by the nurse accurately explains the mechanisms regulating acid-base balance in children?
The respiratory, renal, and chemical-buffering systems
The kidneys balance acid; the lungs balance base
The cardiovascular and integumentary systems
The skin, kidney, and endocrine systems
A child has a 2-day history of vomiting and diarrhea. He has hypoactive bowel sounds and an irregular pulse. Electrolyte values are sodium, 139 mEq/L; potassium, 3.3 mEq/L; and calcium, 9.5 mg/dL. This child is likely to have which of the following electrolyte imbalances?
Hyponatremia
Hypocalcemia
Hyperkalemia
Hypokalemia
Which statement best describes why infants are at greater risk for dehydration than older children?
Infants have an increased ability to concentrate urine.
Infants have a greater volume of intracellular fluid.
Infants have a smaller body surface area
Infants have an increased extracellular fluid volume.
Which assessment is most relevant to the care of an infant with dehydration?
Temperature, heart rate, and blood pressure.
Respiratory rate, oxygen saturation, and lung sounds.
Heart rate, sensorium, and skin color.
Diet tolerance, bowel function, and abdominal girth.
What is the most important factor in determining the rate of fluid replacement in the dehydrated child?
The child’s weight
The type of dehydration
Urine output
Serum potassium level
What is the priority nursing intervention for a 6-month-old infant hospitalized with diarrhea and dehydration?
Estimating insensible fluid loss
Collecting urine for culture and sensitivity
Palpating the posterior fontanel
Measuring the infant’s weight
What assessment should the nurse make before initiating an intravenous (IV) infusion of dextrose 5% in 0.9% normal saline solution with 10 mEq of potassium chloride for a child hospitalized with dehydration?
Fluid intake
Number of stools
Urine output
Capillary refill
A nurse is teaching parents about diarrhea. Which statement by the parents indicates understanding of the teaching?
Diarrhea results from a fluid deficit in the small intestine.
Organisms destroy intestinal mucosal cells, resulting in an increased intestinal surface area.
Malabsorption results in metabolic alkalosis.
Increased motility results in impaired absorption of fluid and nutrients.
What is the best response by the nurse to a parent asking about antidiarrheal medication for her 18-month-old child?
It is okay to give antidiarrheal medication to a young child as long as you follow the directions on the box for correct dosage.”
Antidiarrheal medication is not recommended for young children because it slows the body’s attempt to rid itself of the pathogen.”
I’m sure your child won’t like the taste, so give extra fluids when you give the medication.”
Antidiarrheal medication will lessen the frequency of stools, but give your child Gatorade to maintain electrolyte balance.”
Which action is the primary concern in the treatment plan for a child with persistent vomiting?
Detecting the cause of vomiting
Preventing metabolic acidosis
Positioning the child to prevent further vomiting
Recording intake and output
What is the best response for the nurse to give a parent about contacting the physician regarding an infant with diarrhea?
Call your pediatrician if the infant has not had a wet diaper for 6 hours.”
The pediatrician should be contacted if the infant has two loose stools in an 8-hour period.”
Call the doctor immediately if the infant has a temperature greater than 100° F.”
Notify the pediatrician if the infant naps more than 2 hours.”
Which diet would the nurse recommend to the mother of a child who is having mild diarrhea?
Rice, potatoes, yogurt, cereal, and cooked carrots
Bananas, rice, applesauce, and toast
Apple juice, hamburger, and salad
Whatever the child would like to eat
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