Does any one know the answer to this??

I have been guilty of over-analyzing test questions. My first choice would be Lemonade. Ice tea and diet cola both have caffeine which will diurese the patient.

Milkshake because extra calories are required to make red blood cells to replace the sickled cells.

Typically, you would want to stay away from beverages with caffeine (and that goes for any test question, regardless of condition), so that would leave the lemonade and the milkshake. I would have probably chosen the lemonade simply for the water content.

Also, if you look..........milkshake is like way off (different) than the other 3. They are wanting you to know that especially children (since you mention it's your PEDS rotation), require more calories to produce healthy cells and for growth and maturation.

http://www.drspock.com/article/0,1510,5050,00.html

by Lewis Hsu, M.D., Ph.D. and William Muller, Ph.D reviewed by Laura Jana, M.D., F.A.A.P.

Diet and Nutrition in Sickle Cell Disease:

"Extra calories are required. The calories contained in our food are converted by our bodies into energy that is used to help us grow, ward off infection, and engage in our daily activities....Recent research shows that children with sickle cell need about 20 percent more calories than other children to fuel their production of red blood cells to replace the damaged, sickled ones. Not getting enough calories may lead to delays in growth and maturation. Try to ensure that your child usually snacks on healthy foods, such as fruits, vegetables, and grains, not just junk food. You can work in some additional calories (and protein) by putting peanut butter on celery or carrots; adding cheese, nuts, or wheat germ to appropriate foods; making milkshakes or yogurt smoothies; and serving pudding or instant-breakfast drinks."

you would have to stay away from iced tea since it inhibits the absortion of iron along with the diurese problem mentioned above.

i did find this:

[color=#cc0033]what kind of fluids are needed?

no surprise, water is the best fluid for children with sickle cell to consume. other fluids like juice, milk, soup, fruit, or sports drinks are also fine to add some variation, as are popsicles. on the other hand, drinks with caffeine (cola, coffee), alcohol, or methylxanthine (a stimulant like the caffeine found in tea) are not a good idea. these ingredients make the kidney excrete more water into the urine. if your child is fond of cola or tea, try to limit him to no more than a couple of servings a day.

and this:

inform the patient of the need to increase fluid intake to prevent dehydration due to impaired ability to concentrate urine properly. tell parents to encourage the child to drink more fluids, especially in the summer, by offering fluids such as milkshakes and ice pops.

honestly my answer would have been the lemonade, but i think milkshake might be the answer.

My initial thought was Milkshake for the protein. Then Geeimjo's post supports that. :)

My first thought would be the lemonade due to the caffeine in diet cola and tea. I never thought of milkshake to hydrate however kids may choose it and it does have many cal.

I would of picked lemonade. Can't wait to see the answer, I'm really curious now.

I also would have picked the lemonade, but now I'm thinking it was the milkshake. I thought, oh, it has water and vitamin C from the lemon, but the milkshake has more calories and protein.

Good question. I probably wouldve guesed wrong on an exam, thats for sure.

I guess I'm going against the grain here. The question says on a HOT day I would think they are trying to imply that the purpose of the drink is primarily to keep from becoming dehydrated. So my guess would be the Lemon-aid. It has more calories than water (that has zero) so it meets both the criteria (calories and hydration) everyone is talking about.

One more point. Just like eating snow it takes energy to melt the snow in your mouth leading to very little hydration. Milkshakes being thicker, frozen drinks may take extra energy to process from the time it hits your mouth than lemonaid that is probably higher in sugar and calories but give you loads of water.