You are a PNP in a busy tertiary PICU caring for an 8 year o…

You are a PNP in a busy tertiary PICU caring for an 8 year old admitted for dehydration secondary to feeding intolerance. History includes birth at 24 weeks gestation, cerebral palsy, profound developmental delay and GT dependence. The GI service was consulted and recommended strict NPO for 7-10 days. To provide adequate caloric and nutritional intake, you decide your patient requires total parenteral nutrition (TPN), and subsequently undergoes PICC line placement. The following statements are true regarding this clinical scenario except:

A 3 week old presents to the ED with a 2 day history of poor…

A 3 week old presents to the ED with a 2 day history of poor feeding, decreased urine output, and lethargy. On exam, it is noted that he has a bulging fontanelle. The child was born via spontaneous vaginal delivery and was discharged to home with mom on day 2 of life. In the ED, he was found to have a body temperature of 39.0 C (102.2 F). Before you prepare for a lumbar puncture, you are considering obtaining a CT scan of the head first. Why would this be indicated? 

A 11 year old male with Autism presents with severe dehydrat…

A 11 year old male with Autism presents with severe dehydration secondary to diarrhea. IN the process of electrolyte evaluation and rehydration, he is noted to have excessive urine output and rising serum sodium levels. What is the most likely cause of these findings?

During your evening shift in the emergency department, you a…

During your evening shift in the emergency department, you are asked to see a 9 month old female infant with 2 to 3 day history of several episodes of vomiting and diarrhea. The mother describes him as awake but moderately irritable. On examination, he is alert, with dry mucus membranes, a sunken fontanel, slightly sunken eyes, tachycardia, and 2 to 3 second capillary refill time. His serum Na level is 140. You estimate his percentage of dehydration to be: