Page 943 - Saunders Comprehensive Review For NCLEX-RN

7. For mild to moderate dehydration, provide oral
rehydration therapy with Pedialyte or a similar
rehydration solution as prescribed; avoid carbonated
beverages because they are gas-producing, and fluids
that contain high amounts of sugar, such as apple
juice.
8. For severe dehydration, maintain NPO (nothing by
mouth) status to place the bowel at rest and provide
fluid and electrolyte replacement by the intravenous
(IV) route as prescribed; if potassium is prescribed for
IV administration, ensure that the child has voided
before administering and has adequate renal function.
9. Reintroduce a normal diet when rehydration is
achieved.
10. Provide instructions to the parents about the types and
amounts of fluid to encourage, signs of dehydration,
and indications of the need to notify the PHCP.
III. Phenylketonuria
A. Description
1. Phenylketonuria is a genetic disorder (autosomal
recessive disorder) that results in central nervous
system damage from toxic levels of phenylalanine (an
essential amino acid) in the blood.
2. It is characterized by blood phenylalanine levels
greater than 20 mg/dL (1210 mcmol/L); normal level is
0 to 2 mg/dL (0 to 121 mcmol/L).

3. All 50 states require routine screening of all

newborns for phenylketonuria.
B. Assessment
1. In all children
a. Digestive problems and vomiting
b. Seizures
c. Musty odor of the urine
d. Mental retardation
2. In older children
a. Eczema
b. Hypertonia
c. Hypopigmentation of the hair, skin, and
irises
d. Hyperactive behavior

C. Interventions

1. Screening of newborn infants for phenylketonuria: The
infant should have begun formula or breast milk
feeding before specimen collection.
2. If initial screening is positive, a repeat test is

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