Which nursing intervention is appropriate for a child with type 1 diabetes who is experiencing deficient fluid volume related to abnormal fluid losses through diuresis and emesis? Select all that apply
a. Initiate IV access.
b. Begin IV fluid replacement with normal saline.
c. Begin IV fluid replacement with D5
1/2NS.
d. Weigh on arrival to the unit and then every other day.
e. Maintain strict intake and output monitoring.
A, B, E
Feedback
Correct IV access should always be obtained on a hospitalized child with
dehydration and a history of type 1 diabetes. Maintaining circulation is a
priority nursing intervention. If the child is vomiting and unable to
maintain adequate hydration, fluid volume replacement/rehydration is
needed. Normal saline is the initial IV rehydration fluid, followed by
half-normal saline. Maintaining strict intake and output is essential in
calculating rehydration status.
Incorrect D5
1/2NS is not the recommended fluid for rehydration of this patient.
Weighing the patient on arrival is important, but following the initial
weight, the child needs to be weighed more frequently than every other
day. Comparison of admission weight and a weight every 8 hours provides
an indication of hydration status.
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