When monitoring the daily weight of a patient with fluid volume deficit (FVD), the nurse is aware that fluid loss may be considered when weight loss begins to exceed:
A. 0.25 lb
B. 0.50 lb
C. 1 lb
D. 1 kg
Correct Answer: B. 0.50 lb
Weight loss of more than 0.50 lb. is considered to be a fluid loss. Weigh daily with the same scale, and preferably at the same time of day. Weight is the best assessment data for possible fluid volume imbalance. An increase of 2 lbs a week is considered normal.
Option A: Severe dehydration by clinical examination suggests a fluid deficit of 10-15% of body weight in infants and 6-9% of body weight in older children. The daily maintenance fluid is added to the fluid deficit.
Option C: In general, the recommended administration is one-half of this volume administered over 8 hours and administration of the remainder over the following 16 hours. Continued losses (eg, emesis, diarrhea) must be promptly replaced.
Option D: An alternative approach to the deficit therapy approach is rapid replacement therapy. With this approach, a child with severe isonatremic dehydration is administered 20-40 mL/kg of isotonic sodium chloride solution or lactated Ringer solution over 15-60 minutes.
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