Growth & BMI
This growth chart is used for children ages 0–2 years.
WHO growth chart
Which factor places a school-age child at greatest risk for obesity?
Excessive daily screen time
Expected urine output for children is:
1–2 mL/kg/hr
A 2-year-old child is admitted with vomiting and diarrhea for 24 hours. The child has dry mucous membranes, decreased tears, tachycardia, and delayed capillary refill of 3 seconds. Which intervention should the nurse implement first?
Administer 20 mL/kg isotonic IV fluid bolus
Sodium less than 135 mEq/L is classified as:
Hyponatremia
An 8-year-old with a BMI at the 96th percentile is classified as:
Obesity
Which beverage contributes most to pediatric obesity?
Sugar-sweetened beverages
A toddler with dry mucous membranes, delayed cap refill, and tachycardia is experiencing what stage of dehydration?
Moderate dehydration
A 10 kg infant requires a fluid bolus for severe dehydration. How much isotonic fluid should be administered?
200 mL
A child with hyponatremia is at highest risk for:
Seizures
A BMI between the 85th and 94th percentile is classified as:
Overweight
The gold standard for treating pediatric obesity requires at least how many contact hours over 3–12 months?
≥ 26 hours (IHBLT)
Intensive Health Behavior and Lifestyle Treatment.
Signs of severe dehydration include:
Hypotension, lethargy, anuria, cool extremities
Using the 4-2-1 rule, how many mL/hr does a 15 kg child need?
(10×4 = 40)
(5×2 = 10)
Total = 50 mL/hr
The 4-2-1 rule is:
4 mL/kg/hr for the first 10 kg
2 mL/kg/hr for the next 10 kg
1 mL/kg/hr for every kg over 20 kg
First medication given to stabilize the heart during hyperkalemia is:
Calcium gluconate
An 8-year-old has a BMI at the 96th percentile. What is the nurse’s best interpretation?
The child meets criteria for obesity and requires further assessment and counseling.
A parent says, “My child is just big-boned.” What is the nurse’s best response?
Discuss growth percentiles objectively and ask permission to talk about healthy habits.
First-line treatment for mild to moderate dehydration is:
Oral Rehydration Therapy (ORT)
Why are isotonic fluids preferred over hypotonic fluids in hospitalized children?
To prevent iatrogenic hyponatremia (Preventing low sodium that happens because of the fluids or treatments we give.)
A child with CF attending summer soccer camp should use which strategy to prevent salt depletion?
Increase salt intake and use electrolyte-containing fluids
Which statement reflects appropriate therapeutic communication when discussing weight?
A. “Your child is obese.”
B. “Your child is very overweight.”
C. “Your child’s growth pattern suggests an unhealthy weight. Can we talk about it?”
D. “Your child needs to lose weight.”
C. “Your child’s growth pattern suggests an unhealthy weight. Can we talk about it?”
Which comorbidity should be screened for in children with obesity starting at age 10?
Type 2 diabetes
A 2-year-old with sunken fontanelle, HR 170, and poor perfusion requires what immediate intervention?
20 mL/kg isotonic IV bolus
Total body water percentage is highest in which population?
Neonates
Why is a child with bronchiolitis at increased risk for dehydration?
Increased respiratory rate increases insensible fluid loss