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Gastroenteritis/Stomach Flu (10 Questions)
1. Mme Lefebvre arrives at the emergency department with her 7-month-old son, Noah. She states, "He has had watery diarrhea and vomiting for 2 days. He hasn't kept any milk down today, and he seems very tired." Noah is irritable when touched but otherwise lethargic.
Question:
Which specific physical assessment finding by the nurse indicates that the infant is experiencing moderate to severe dehydration?
*
The anterior fontanel appears depressed and sunken.
The posterior fontanel appears depressed and sunken.
The capillary refill time is less than 2 seconds.
The skin is flushed and warm to the touch.
2. Lucas, a 4-year-old, was admitted 6 hours ago for severe gastroenteritis. He has received oral rehydration therapy. You are reviewing his latest blood and urine laboratory results to determine his hydration status.
The results are:
*Hematocrit: 0.52 (52%)
*Urine Specific Gravity: 1.035
*Serum Sodium: 148 mmol/L
Question:
How should the nurse interpret these laboratory findings?
*
The child is over-hydrated; the fluid intake should be restricted.
The results are normal for a child of this age; continue current care.
The child has renal failure requiring immediate dialysis.
The child remains dehydrated.
3. Mme Gagnon calls the Info-Santé line. Her 2-year-old daughter has had 3 episodes of loose stools and vomiting this morning but is alert and playing. Mme Gagnon asks, "What should I give her to drink to prevent dehydration? I have apple juice, chicken broth, and water."
Question:
What is the best evidence-based recommendation?
*
"Give her full-strength apple juice because the sugar gives her energy."
"Give her chicken broth because the salt helps retain fluid."
"Offer an oral rehydration solution (like Pedialyte) in small, frequent amounts."
"Give her nothing by mouth (NPO) for 4 hours to let her stomach settle."
4. Baby Tremblay, 10 months old, is admitted to the pediatric unit with a diagnosis of Rotavirus Gastroenteritis. The unit is busy, and you are assigning rooms.
Question:
Which isolation precaution is required for this patient to prevent the spread of infection?
*
Droplet Precautions (Mask and eye protection).
Contact Precautions (Gown and gloves).
Airborne Precautions (N95 mask and negative pressure room).
Reverse Isolation (Protecting the patient from others).
5. Jérémie, age 3, is admitted with severe dehydration. The physician orders: "IV D5W + 0.45% NaCl with 20 mEq/L KCl at 60 mL/hr." You are preparing to hang the bag.
Question:
Before administering the IV fluid containing Potassium (KCl), which assessment is essential?
*
Verify that the child has voided.
Check if the child has a fever.
Ensure the child has passed a stool.
Check the child's blood glucose level.
6. Mme Roy is preparing to take her 5-year-old son home after he was treated for gastroenteritis. He has not vomited in 12 hours. She asks, "Should I stick to just bananas, rice, and toast (BRAT diet) for a few days?"
Question:
What is the current standard of care regarding nutrition during recovery?
*
"Yes, the BRAT diet is the only safe option for 72 hours."
"No, the BRAT diet is low in protein and energy. He should resume a regular, age-appropriate diet as tolerated."
"He should remain on clear liquids only until the diarrhea stops completely."
"He should drink only milk to coat his stomach."
7. Baby Bouchard (9 months old) is brought to the clinic. Her pre-illness weight documented 3 days ago was 10.0 kg. Today, after 3 days of vomiting and diarrhea, she weighs 9.0 kg.
Question:
Based on the weight loss, how would the nurse classify the severity of the dehydration?
*
Mild (approx 3%).
Moderate (approx 5-6%).
Severe (10%).
No dehydration.
8. Mme Caron asks the nurse if she can give her 6-year-old son an over-the-counter antidiarrheal medication (like Loperamide/Imodium) to stop the diarrhea so he can sleep through the night.
Question:
What is the correct nursing response?
*
"Yes, giving half the adult dose is safe for a 6-year-old."
"You should give it only if there is blood in the stool."
"It is generally not recommended for children because diarrhea is the body's way of getting rid of the virus or bacteria."
"Give it immediately; preventing dehydration is the only goal."
9. Due to frequent liquid stools, Baby Poirier, 8 months old, has developed bright red, raw, weeping skin on the buttocks and perineum. The baby cries whenever the diaper is changed.
Question:
What is the best nursing intervention to promote healing?
*
Cleanse the area vigorously with commercial alcohol wipes to kill bacteria.
Apply baby powder (talc) to keep the area dry.
Use a hairdryer on the hot setting to dry the skin.
Apply a thick layer of a barrier cream containing zinc oxide or petroleum jelly at every diaper change.
10. Mme Dubé brings her 18-month-old, Alice, to the ER. Alice is unresponsive to voice. Her skin is mottled and cool. Her heart rate is 170 bpm, and her blood pressure is 60/40 mmHg. Oral rehydration is not possible due to her level of consciousness.
Question:
The nurse recognizes decompensated shock. What is the priority intervention?
*
Insert an NG tube for Pedialyte administration.
Administer an IV bolus of Dextrose 10% (D10W).
Administer a dose of IV Ondansetron (Zofran) to stop vomiting.
Administer an IV bolus of 20 mL/kg of Isotonic Crystalloid (Normal Saline or Lactated Ringer's).