The nurse receives shift report on a pediatric medical-surgical unit. The nurse has been assigned four clients for the shift. Which client does the nurse plan to assessment first based on the increased risk for dehydration?
A) A 4-year-old child with a broken leg
B) A 15-month-old child with tachypnea
C) A 16-year-old child with migraine headaches
D) A 10-year-old child with cellulitis of the left leg
Answer: B
The pediatric client with the greatest risk for dehydration is the client who is under 2 years of age experiencing tachypnea which increases insensible fluid loss. The pediatric client with a chronic or acute condition that does not directly affect the GI or electrolyte system (migraine headache, broken leg, or cellulitis) is at a lower risk than is a toddler with a condition that increases insensible water loss.
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