Identifying Dehydration in a Pediatric Patient: Interpretation of Laboratory Values

QUESTION

Exit Exam A child is admitted to the hospital unit for gastroenteritis and dehydration. Which laboratory values does the nurse interpret as indicative of dehydration?

ANSWER

Identifying Dehydration in a Pediatric Patient: Interpretation of Laboratory Values”

In the context of a child admitted to the hospital unit for gastroenteritis and dehydration, several laboratory values can be indicative of dehydration. Let’s examine each of the options:

Elevated Hemoglobin and Hematocrit
Elevated hemoglobin and hematocrit levels can suggest dehydration. Dehydration reduces the plasma volume in the blood, leading to hemoconcentration, which results in higher hemoglobin and hematocrit values. This is due to a relative increase in the concentration of red blood cells in the blood when there is less fluid.

Decreased Urine-Specific Gravity
Dehydration can lead to increased urine-specific gravity. In a dehydrated state, the body conserves water, and as a result, urine becomes more concentrated, leading to higher urine-specific gravity values. Therefore, the interpretation would be the opposite: dehydration is associated with increased urine-specific gravity, not decreased.

Elevated White Blood Cell (WBC) Count
An elevated WBC count is not typically considered an indicator of dehydration. Elevated WBC counts are often associated with infection or inflammation rather than dehydration.

Elevated Lymphocytes in the WBC Differential
Elevated lymphocytes in the WBC differential can be indicative of various conditions, including infections, but they are not specific to dehydration.

In summary, the laboratory values that the nurse should interpret as indicative of dehydration in this scenario are **elevated hemoglobin and hematocrit** due to hemoconcentration resulting from reduced plasma volume. The other options, including an elevated WBC count, decreased urine-specific gravity, and elevated lymphocytes in the WBC differential, are not direct indicators of dehydration.

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