The nurse is caring for a preschool child immobilized by a spica ...

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The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status?
 
  a. Hypocalcemia
  b. Decreased metabolic rate
  c. Positive nitrogen balance
  d. Increased production of stress hormones

Question 2

A nurse is caring for a 5-year-old child with a major burn. The health care provider has written a prescription to notify the health care provider if urine output falls to or below 2 ml/kg/hr.
 
  The child weighs 55 lb. The nurse should notify the health care provider if the milliliters of urine output is at or below _____ for an hour. (Record your answer in a whole number.)
  What will be an ideal response?

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Answer to Question 1

ANS: B
Immobilization causes a decreased metabolic rate with slowing of all systems and a decreased food intake. Immobilization leads to hypercalcemia and causes a negative nitrogen balance secondary to muscle atrophy. A decreased production of stress hormones occurs with decreased physical and emotional coping capacity.

Answer to Question 2

ANS:
50
The primary emphasis during the emergent phase is the treatment of burn shock and the management of pulmonary status. Monitoring vital signs, output, fluid infusion, and respiratory parameters are ongoing activities in the hours immediately after injury. IV infusion is begun immediately and is regulated to maintain a urinary output of at least 1 to 2 ml/kg in children weighing less than 30 kg (66 pounds). To calculate the child's weight in kilograms, the weight in pounds is divided by 2.2. That number is then multiplied by 2 to get the amount expected for a 1-hour period. 55/2.2 = 25 kg. 25 kg  2 ml = 50 ml per hour.

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