Practice Quiz

CCNS Certified Clinical Nurse Specialist

Category - Pediatrics

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A nurse is assessing fluid balance in a fourteen-year-old patient after a craniotomy. The nurse should assess for which of the following as a sign of dehydration, which could aggravate cerebral edema?
  1. BUN of 10 mg/dL
  2. Serum osmolality of 305 mOsm/kg H2O
  3. Shift intake of 800 mL and output of 750 mL
  4. Unchanged weight
Explanation
Answer - B - The nurse should assess for serum osmolality of 205 mOsm/kg H20 as a sign of dehydration, which could aggravate cerebral edema. The normal serum osmolality is 285 - 295 mOsm/kg H2O. BUN is within the normal range. A difference of 50 ml in intake and output in a shift is insignificant.
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