London_TIF_Ch46
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London_TIF_Ch46

Course Number: NURSING 75789, Spring 2013

College/University: FAU

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Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. Chapter 46: The Child with Alterations in Fluids, Electrolytes, and AcidBase Balance Chapter 46_LO01_Q01 The neonatal nurse explains to new parents that infants are at greater risk for fluid and electrolyte imbalance than are older children. Which of the following parent comments would indicate that further education is needed? 1....

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46: Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. Chapter The Child with Alterations in Fluids, Electrolytes, and AcidBase Balance Chapter 46_LO01_Q01 The neonatal nurse explains to new parents that infants are at greater risk for fluid and electrolyte imbalance than are older children. Which of the following parent comments would indicate that further education is needed? 1. "Infants have a higher metabolic rate than older children do." 2. "An infant has little body water for reserve, as compared with an adult." 3. "Infants lose water through their skin, and they have a larger proportion of skin surface area than older children do." 4. "Infants maintain their temperature by losing heat through their heads." Correct Answer: 4 Rationale: 1. This is a true statement. 2. This is a true statement. 3. This is a true statement. 4. Losing heat through their heads will have minimal affect on fluid loss in infants. Cognitive Level: Analysis Category of Client Need: Physiological Integrity Nursing Process: Evaluation Learning Outcome: 46.1 Describe normal fluid and electrolyte status for children at various ages. Chapter 46_LO02_Q02 A 6-month-old infant is admitted with severe dehydration. Effectiveness of therapy is evaluated with which of the following assessment measures? Select all that apply. 1. Record intake and output accurately. 2. Daily weights on the same scale, same time, with no clothes 3. Document mucous membrane moisture every shift. 4. Evaluate level of consciousness continuously. 5. Document abdominal girth every shift. Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. Correct Answers: 1; 2; 3; 4 Rationale: 1. All of the choices represent assessment measures that measure the effectiveness of therapy except abdominal girth, which does not provide information regarding hydration status. 2. All of the choices represent assessment measures that measure the effectiveness of therapy except abdominal girth, which does not provide information regarding hydration status. 3. All of the choices represent assessment measures that measure the effectiveness of therapy except abdominal girth, which does not provide information regarding hydration status. 4. All of the choices represent assessment measures that measure the effectiveness of therapy except abdominal girth, which does not provide information regarding hydration status. 5. All of the choices represent assessment measures that measure the effectiveness of therapy except abdominal girth, which does not provide information regarding hydration status. Cognitive Level: Analysis Category of Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome: 46.2 Identify regulatory mechanisms for fluid and electrolyte balance. Chapter 46_LO03_Q03 A nurse is taking care of four different pediatric clients. The client with the greatest risk for dehydration is the child: 1. Over 2 years of age with migraine headaches. 2. Under 2 years of age with tachypnea. 3. Over 2 years of age with a broken arm. 4. Under 2 years of age with cellulitis of the left leg. Correct Answer: 2 Rationale: 1. The pediatric client with the greatest risk is the one under 2 years of age with a condition that increases insensible fluid loss. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system is at a lower risk than a client with a condition that increases insensible water lossin this case, tachypnea. Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 2. The pediatric client with the greatest risk is the one under 2 years of age with a condition that increases insensible fluid loss. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system is at a lower risk than a client with a condition that increases insensible water lossin this case, tachypnea. 3. The pediatric client with the greatest risk is the one under 2 years of age with a condition that increases insensible fluid loss. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system is at a lower risk than a client with a condition that increases insensible water lossin this case, tachypnea. 4. The pediatric client with the greatest risk is the one under 2 years of age with a condition that increases insensible fluid loss. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system is at a lower risk than a client with a condition that increases insensible water lossin this case, tachypnea. Cognitive Level: Analysis Category of Client Need: Safe, Effective Care Environment Nursing Process: Planning Learning Outcome: 46.3 Recognize threats to fluid and electrolyte balance in children. Chapter 46_LO03_Q04 The nurse has just finished a parent teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught? 1. Hydration should occur at the end of an exercise session. 2. Water is the drink of choice to replenish fluids. 3. Wearing dark clothing during exercise is recommended. 4. During activity, stop for fluids every 1520 minutes. Correct Answer: 4 Rationale: 1. Hydration should occur before and during the activity, not just at the end. 2. A combination of water and sports drinks is best to replace fluids during exercise. Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 3. Light-colored, light clothing is best to wear during exercise activities. Wearing of dark colors can increase sweating. 4. During activity, stopping for fluids every 1520 minutes is recommended. Cognitive Level: Analysis Category of Client Need: Health Promotion and Maintenance Nursing Process: Evaluation Learning Outcome: 46.3 Recognize threats to fluid and electrolyte balance in children. Chapter 46_LO04_Q05 A child with croup has an increased PCO2 a decreased pH, and a normal HCO3 blood gas value. The nurse interprets this as uncompensated: 1. Respiratory acidosis. 2. Respiratory alkalosis. 3. Metabolic acidosis. 4. Metabolic alkalosis. Correct Answer: 1 Rationale: 1. If the pH is decreased and the PCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Also, croup can be a disease process that causes respiratory acidosis. 2. Respiratory alkalosis, uncompensated, has an increased pH, decreased PCO2, and normal HCO3. 3. Metabolic acidosis, uncompensated, has a decreased pH, normal PCO2, and normal HCO3. 4. Metabolic alkalosis, uncompensated, has an increased pH, normal PCO2, and increased HCO3. Cognitive Level: Analysis Category of Client Need: Physiological Integrity Nursing Process: Planning Learning Outcome: 46.4 Describe acidbase balance and recognize disruptions common in children. Chapter 46_LO05_Q06 Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert, but has dry mucous membranes. Which other sign indicates that the infant still is in the early or mild stage of dehydration? 1. Tachycardia 2. Bradycardia 3. Increased blood pressure 4. Decreased blood pressure Correct Answer: 1 Rationale: 1. Tachycardia is a sign that indicates mild dehydration. 2. Bradycardia is not a sign of dehydration. 3. Increased blood pressure is not a sign of dehydration. 4. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate-to-severe dehydration. Cognitive Level: Analysis Category of Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome: 46.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children. Chapter 46_LO05_Q07 In the morning, a nurse receives a report on four pediatric clients, each of whom has some form of fluid volume excess. Which child should the nurse check first? The child with: 1. Periorbital edema, normal respiratory rate. 2. Tachypnea and pulmonary congestion. 3. Dependent and sacral edema, regular pulse. 4. Hepatomegaly, normal respiratory rate. Correct Answer: 2 Rationale: Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 1. The child with periorbital edema and normal respiratory rate is more stable than the child with tachypnea and pulmonary congestion. 2. A child with respiratory distress should be the first client the nurse checks after receiving the report. 3. The child with dependent and sacral edema is more stable than the child with tachypnea and pulmonary congestion. 4. The child with hepatomegaly and normal respiratory rate is more stable than the child with tachypnea and pulmonary congestion. Cognitive Level: Application Category of Client Need: Safe, Effective Care Environment Nursing Process: Implementation Learning Outcome: 46.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children. Chapter 46_LO05_Q08 A nurse is planning care for a child with hyponatremia. The nurse delegating care of this child to an LVN cautions the LVN about which complication? 1. Seizures 2. Bradycardia 3. Respiratory distress 4. Answer: Hyperthermia Correct 1 Rationale: 1. A child with hyponatremia is at risk for seizures. 2. Bradycardia is not a risk of hyponatremia. 3. Respiratory distress is not a risk of hyponatremia. 4. Hyperthermia is not a risk of hyponatremia. Cognitive Level: Analysis Category of Client Need: Safe, Effective Care Environment Nursing Process: Planning Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. Learning Outcome: 46.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children. Chapter 46_LO05_Q09 A 1-month-old infant is admitted to the Emergency Department with severe diarrhea. Which assessment suggests the infant is severely dehydrated? 1. Skin moist and flushed; mucous membranes dry 2. Low specific gravity of urine; skin color pale 3. Fontanelles depressed; capillary refill greater than 3 seconds 4. High specific gravity of urine; moist mucous membranes Correct Answer: 3 Rationale: 1. Moist, flushed skin is not a sign of dehydration. Dry mucous membranes are signs of mild, not severe, dehydration. 2. Low specific gravity of urine and pale skin color are not signs of dehydration. 3. Two signs of severe dehydration are depressed fontanelles and capillary refill time greater than 3 seconds. 4. High specific gravity of urine and moist mucous membranes are not signs of severe dehydration. Cognitive Level: Analysis Category of Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome: 46.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid-base imbalance in children. Chapter 46_LO06_Q10 The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids? 1. D5W 2. 0.9% normal saline Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 3. Albumin 4. D5 0.2% (1/4) normal saline Correct Answer: 2 Rationale: 1. D5W can lower sodium levels, and so would not be used initially to replace fluids in severe isotonic dehydration. 2. 0.9% normal saline maintains Na and chloride at present levels. 3. Albumin is used to restore plasma proteins. 4. D5 0.2% (1/4) normal saline would be used later, as maintenance fluids. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance. Chapter 46_LO06_Q11 Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highconcentrated formula. Which is the most appropriate response by the nurse? 1. A higher-concentrated formula could lead to dehydration because of high sodium content. Lets discuss other strategies. 2. An undiluted formula concentrate could be given to help the child gain weight. Lets look at brands. 3. Evaporated milk could be given to the infant instead of the current formula youre using. 4. A higher-concentrated formula could be given for daytime feedings. Lets work on a schedule. Correct Answer: 1 Rationale: 1. Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content. Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 2. Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content. 3. Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content. 4. Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance. Chapter 46_LO06_Q12 A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg, and is estimated to have lost 7% of her normal body weight. The nurse is double-checking the IV rate the physician has ordered. Replacement fluid is the percentage of lost body weight 10 per kg of body weight. According to the calculation for maintenance and replacement fluid, this childs hourly IV rate for 24 hours should be _______. Correct Answer: 86 Rationale: Maintenance needs for 13 kg is 1000 + (50 3), or 1150 mL/24 hr. Add to this the replacement fluid loss = 7 (percent of total body weight lost) 10 = 70 mL/kg/24hr (70 13 = 910). 1150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance. Chapter 46_LO06_Q13 Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. An infant is in the hospital for hypernatremia. Which of the following is the most appropriate means of collecting urine for a specific gravity test? 1. Placing cotton balls in the diaper and then (wearing gloves) squeezing a drop of urine from the cotton balls onto the specific gravity test strip 2. Performing a sterile in-and-out catheterization to collect urine for the specific gravity test strip 3. Placing a urine collection bag on the infant 4. Inserting a Foley catheter to obtain a sterile urine specimen for the specific gravity test strip Correct Answer: 1 Rationale: 1. Urine for a specific gravity test should be collected by placing cotton balls in the diaper. Only a small amount of clean (uncontaminated from stool) urine is needed to do a specific gravity test. 2. An in-and-out catheter would be invasive for this clean collection of a small amount of urine. 3. A urine bag can be irritating to the skin and would not be appropriate for collecting a small amount of urine for a specific gravity test. 4. A Foley catheter would be invasive for this clean collection of a small amount of urine. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance. Chapter 46_LO06_Q14 A 6-year-old child is hypokalemic. The nurse is helping the child choose menu items. The nurse would encourage this child to select which foods? 1. Hamburger with French fries 2. Pizza with a fruit plate 3. Chicken strips with chips 4. Fajita with rice Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. Correct Answer: 2 Rationale: 1. Pizza with a fruit plate should be encouraged because fruit (bananas, apricots, cantaloupe, cherries, peaches, and strawberries) have high amounts of potassium, and a child is likely to eat this combination. The other choices would not be as high in potassium. 2. Pizza with a fruit plate should be encouraged because fruit (bananas, apricots, cantaloupe, cherries, peaches, and strawberries) have high amounts of potassium, and a child is likely to eat this combination. The other choices would not be as high in potassium. 3. Pizza with a fruit plate should be encouraged because fruit (bananas, apricots, cantaloupe, cherries, peaches, and strawberries) have high amounts of potassium, and a child is likely to eat this combination. The other choices would not be as high in potassium. 4. Pizza with a fruit plate should be encouraged because fruit (bananas, apricots, cantaloupe, cherries, peaches, and strawberries) have high amounts of potassium, and a child is likely to eat this combination. The other choices would not be as high in potassium. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Intervention Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance. Chapter 46_LO06_Q15 A child is admitted to the hospital for hypercalcemia, and is placed on diuretic therapy. Which diuretic would the nurse expect to give? 1. Hydrochlorothiazide (Aquazide) 2. Spironolactone (Aldactone) 3. Furosemide (Lasix) 4. Mannitol (Osmitrol) Correct Answer: 3 Rationale: Londonetal.,Maternal&ChildNursingCare,3e 2011byPearsonEducation,Inc. 1. Thiazide diuretics (hydrochlorothiazide) decrease calcium excretion, and should not be given to the hypercalcemic client. 2. Spironolactone (Aldactone) is a potassium-sparing diuretic, and would not be effective for excretion of calcium. 3. Furosemide (Lasix) is the diuretic used to aid in excretion of calcium. 4. Mannitol (Osmitrol) is a diuretic used to decrease cerebral edema, and is not routinely used to aid in excretion of calcium. Cognitive Level: Application Category of Client Need: Physiological Integrity Nursing Process: Planning Learning Outcome: 46.6 Describe appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid-base imbalance.

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UNIVERSITY OF ZARAGOZAPHD THESISto obtain the title ofPhD of System Engineering and Computer Scienceof the University of ZaragozaDefended byJavier Civera SanchoReal-Time EKF-Based Structure from MotionThesis Advisor: Jos Mar Mart e ia inez Montiel
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Color-encoded fringe projection for 3D shape measurementsWei-Hung SuDepartment of Material Science and Optoelectronic Engineering, National Sun Yat-Sen University Kaohsiung 804, Taiwan wxs156@mail.nsysu.edu.twAbstract: A novel technique using color-enc
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Gorthi, S. S. and Rastogi, P. Optics and Lasers in Engiering, 48(2):133-140, 2010.Fringe Projection Techniques: Whither we are?Sai Siva Gorthi and Pramod RastogiApplied computing and mechanics laboratory, Swiss Federal Institute of Technology, 1015 Lau
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Incremental Structure from Motion for Large Ordered and Unordered Sets of ImagesA Dissertation Presented to the Faculty of the Electrical Engineering of the Czech Technical University in Prague in Partial Fulfillment of the Requirements for the Ph.D. Deg
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S HAPE R EPRESENTATIONSFORANDA LGORITHMS3D M ODEL R ETRIEVALM ICHAEL M. K AZHDANA D ISSERTATION P RESENTEDOF IN TO THEFACULTYP RINCETON U NIVERSITYFOR THEC ANDIDACYOFD EGREED OCTOROFP HILOSOPHYR ECOMMENDED BYTHEFORACCEPTANCEOFD EPART
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Eliminating Ghosting and Exposure Artifacts in Image MosaicsMatthew Uyttendaele Microsoft Research AbstractAs panoramic photography becomes increasingly popular, there is a greater need for high-quality software to automatically create panoramic images.
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Pattern Recognition Letters 24 (2003) 16631677 www.elsevier.com/locate/patrecA new algorithm for unsupervised global and local color correctionAlessandro Rizziaa,*, Carlo Gatta a, Daniele MarinibDepartment of Information Technology, University of M
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Object reconstruction in multilayer neural network based profilometry using grating structure comprising two regions with different spatial periodsDinesh Ganotra, Joby Joseph, Kehar Singh*Photonics Group, Department of Physics, Indian Institute of Techn
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High-speed 3-D shape measurement based on digital fringe projectionPeisen S. Huang Chengping Zhang Fu-Pen Chiang SUNY at Stony Brook Department of Mechanical Engineering Stony Brook, New York 11794-2300 E-mail: chenzhan@ic.sunysb.edu Abstract. A high-spe
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Liu et al.Vol. 27, No. 3 / March 2010 / J. Opt. Soc. Am. A553Gamma model and its analysis for phase measuring profilometryKai Liu,1,3 Yongchang Wang,1,* Daniel L. Lau,1,4 Qi Hao,2,5 and Laurence G. Hassebrook1,61 2Electrical and Computer Engineering
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Periodicity Algorithm for Double Error Correcting Reed-Solomon CodesSon Le-Ngoc and Zhenpen Young son_le_ngoc@hotmail.com Duy Tan University, 184 Nguyen Van Linh, Da Nang City, Vietnam. www.duytan.edu.vnABSTRACT In this paper, the periodicity algorithm