the nurse is caring for a child with sickle cell anemia with the following order morphine sulfate 2 mg iv every 24 hours morphine sulfate is available
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Nursing Care of Children ATI

1. The nurse is caring for a child with sickle cell anemia with the following order: Morphine Sulfate 2 mg IV every 24 hours. Morphine Sulfate is available in 10 mg/1mL. How many mL should the nurse administer?

Correct answer: A

Rationale: To administer 2 mg of Morphine Sulfate when the concentration is 10 mg/mL, the nurse should administer 0.2 mL (2 mg / 10 mg/mL = 0.2 mL). Choice B, 0.5 mL, is incorrect because it is the result of dividing 2 mg by 4 mg/mL instead of 10 mg/mL. Choice C, 1 mL, is incorrect as it would be the result of dividing 2 mg by 2 mg/mL. Choice D, 2 mL, is incorrect as it would be the result of dividing 2 mg by 1 mg/mL.

2. What is the required number of milliliters of fluid needed per day for a 14-kg child?

Correct answer: D

Rationale: The fluid requirement for a 14-kg child is approximately 100 mL/kg/day, so for a 14-kg child, the requirement is around 1400 mL/day.

3. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?

Correct answer: C

Rationale: The correct recommendation for decreasing the number and total volume of emesis in an infant with gastroesophageal reflux is to thicken feedings and enlarge the nipple hole. Thicker feedings can reduce the frequency and volume of emesis by making the food less likely to be regurgitated. Enlarging the nipple hole helps ensure the thickened feedings can pass through. Surgical therapy (Choice A) is not the initial recommendation for managing gastroesophageal reflux in infants. Placing the infant in a prone position for sleep after feeding (Choice B) is not recommended due to the increased risk of sudden infant death syndrome (SIDS). Reducing the frequency of feeding by encouraging larger volumes of formula (Choice D) can exacerbate the reflux symptoms.

4. Nurses should be alert for increased fluid requirements in which circumstance?

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

5. What is the best indicator of fluid balance in a pediatric patient?

Correct answer: C

Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.

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