Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
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Chapter 18: The Child with a Fluid and Electrolyte Alteration
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| a. | The respiratory, renal, and chemical-buffering systems |
| b. | The kidneys balance acid; the lungs balance base |
| c. | The cardiovascular and integumentary systems |
| d. | The skin, kidney, and endocrine systems |
ANS: A
| Feedback | |
| A | The acid-base system is regulated by chemical buffering, respiratory control of carbon dioxide, and renal regulation of bicarbonate and secretion of hydrogen ions. |
| B | Both the kidneys and the lungs, along with the buffering system, contribute to acid-base balance. Neither system regulates acid or base balances exclusively. |
| C | The cardiovascular and integumentary systems are not part of acid-base regulation in the body. |
| D | Chemical buffers, the lungs, and the kidneys work together to keep the blood pH within normal range. |
DIF: Cognitive Level: Knowledge REF: Text Reference: pg 488
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
| a. | Hyponatremia |
| b. | Hypocalcemia |
| c. | Hyperkalemia |
| d. | Hypokalemia |
ANS: D
| Feedback | |
| A | The normal serum sodium level is 135 to 145 mEq/L. A level of 139 mEq/L is within normal limits. |
| B | A serum calcium level less than 8.5 mg/dl is considered hypocalcemia. |
| C | A serum potassium level greater than 5 mEq/L is considered hyperkalemia. |
| D | A serum potassium level less than 3.5 mEq/L is considered hypokalemia. Clinical manifestations of hypokalemia include muscle weakness, decreased bowel sounds, cardiac irregularities, hypotension, and fatigue. |
DIF: Cognitive Level: Analysis REF: Text Reference: pg 489
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
| a. | Infants have an increased ability to concentrate urine. |
| b. | Infants have a greater volume of intracellular fluid. |
| c. | Infants have a smaller body surface area. |
| d. | Infants have an increased extracellular fluid volume. |
ANS: D
| Feedback | |
| A | Because the kidneys are immature in early infancy, there is a decreased ability to concentrate the urine. |
| B | Infants have a larger proportion of fluid in the extracellular space. |
| C | Infants have proportionately greater body surface area in relation to body mass, which creates the potential for greater fluid loss through the skin and gastrointestinal tract. |
| D | The larger ratio of extracellular fluid to intracellular fluid predisposes the infant to dehydration. |
DIF: Cognitive Level: Comprehension REF: Text Reference: pg 487
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
| a. | Temperature, heart rate, and blood pressure |
| b. | Respiratory rate, oxygen saturation, and lung sounds |
| c. | Heart rate, sensorium, and skin color |
| d. | Diet tolerance, bowel function, and abdominal girth |
ANS: C
| Feedback | |
| A | Children can compensate and maintain an adequate cardiac output when they are hypovolemic. Blood pressure is not as reliable an indicator of shock as are changes in heart rate, sensorium, and skin color. |
| B | Respiratory assessments will not provide data about impending hypovolemic shock. |
| C | Changes in heart rate, sensorium, and skin color are early indicators of impending shock in the child. |
| D | Diet tolerance, bowel function, and abdominal girth are not as important indicators of shock as heart rate, sensorium, and skin color. |
DIF: Cognitive Level: Analysis REF: Text Reference: pg 494
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
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