A child has a larger body surface area than an adult and is therefore at
increased risk for fluid and heat loss
Rationale: A child has a larger body surface area than an adult
and is therefore at increased risk for fluid and heat loss. Children
are also at increased risk for dehydration and metabolic acidosis
stemming from diarrhea, evaporative water loss, and increased
fluid requirements. A child’s skin is thinner than an adult’s;
therefore lower burn temperatures and shorter exposure to heat
or chemicals can result in a more severe burn. The higher
proportion of body fluid to mass in children increases the risk of
cardiovascular problems because of the less effective
cardiovascular response to changing intravascular volume.
Children are at increased risk for protein and calorie deficiency
because they have smaller muscle mass and lower body fat
than do adults.
Test-Taking Strategy: Focus on the subject, a severe burn injury
in a child. Knowledge regarding the physiological differences
between children and adults and the effects of a burn injury is
needed to answer this question. Read each option carefully,
thinking about the anatomy and physiology of a child. Review
the physiological differences between children and adults.
Level of Cognitive Ability: Understanding
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Child Health—Integumentary
Giddens Concepts: Development, Tissue Integrity
HESI Concepts: Developmental, Tissue Integrity
Reference: McKinney, E., James, S., Murray, S., Nelson, K. &
Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 1323). St.
Louis: Elsevier.
Rationale: After cardiac catheterization, the affected leg is kept
straight for 4 to 6 hours. Keeping the infant in the crib does not
ensure that the affected leg will remain in a straight position. The
infant may be held prone on a parent’s lap. Older children
remain in bed, with the head of the bed raised just 20 degrees.
Test-Taking Strategy: Focus on the subject, cardiac
catheterization in an infant. Visualize each of the options and
recall that the affected leg must remain straight. This will direct
you to the correct option. Review care after cardiac
catheterization.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Child Health—Cardiovascular
Giddens Concepts: Client Education, Clotting
HESI Concepts: Teaching and Learning/Patient Education,
Perfusion/Clotting
Reference: Hockenberry, M, & Wilson, D. (2015). Wong’s
nursing care of infants and children (10th ed. p. 1260). St Louis:
Mosby.
Question 3 pts
After an unplanned cesarean section, the nurse finds the client in
emotional distress, tearfully expressing bewilderment, sadness, and
feelings of failure and regret because she could not deliver vaginally.
Which conclusion should the nurse make?
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