9: Peds N/V Flashcards

1
Q

Mild, moderate, or severe dehydration?

RR is normal.

A

Mild

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2
Q

Mild, moderate, or severe dehydration?

Thirst is moderately increased.

A

Moderate

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3
Q

Mild, moderate, or severe dehydration?

Tachycardia or bradycardia.

A

Severe

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4
Q

Mild, moderate, or severe dehydration?

Eyes are normal.

A

Mild

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5
Q

Mild, moderate, or severe dehydration?

LOC is irritable or lethargic (infants and very young children). Alert, thirsty, restless (older children).

A

Moderate

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6
Q

In dehydration, what is the initial period of bowel rest?

A

1-2 hours

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7
Q

Mild, moderate, or severe dehydration?

  • Urine output is decreased (<1 mL/kg/hr).
  • Dark color.
  • Increased specific gravity.
A

Moderate

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8
Q

Mild, moderate, or severe dehydration?

Mucus membranes are parched.

A

Severe

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9
Q

Mild, moderate, or severe dehydration?

10% or more body weight loss.

A

Severe

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10
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

Greater water loss than salt loss.

A

Hypertonic/Hypernatremic

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11
Q

Mild, moderate, or severe dehydration?

Thirst is greatly increased unless lethargic.

A

Severe

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12
Q

Mild, moderate, or severe dehydration?

Delayed cap refill (>2 sec).

A

Moderate

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13
Q

What are 5 risk factors for dehydration in N/V?

A
  1. Increased extracellular fluid percentage and an increase in body water compared to adults.
  2. Increased basal metabolic rate.
  3. Increased body surface area.
  4. Immature renal function.
  5. Increase insensible fluid loss through temperature elevation.
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14
Q

Mild, moderate, or severe dehydration?

Skin turgor is poor.

A

Moderate

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15
Q

Mild, moderate, or severe dehydration?

BP is normal or low. Postural hypotension (older children).

A

Moderate

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16
Q

What is treatment for severe dehydration?

A
  • NS or LR solution.
  • 20-40 mL/kg bolus.
  • Repeat as needed.
  • Begin oral therapy when more alert.
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17
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

Sodium loss greater than water loss.

A

Hypotonic/Hyponatremic

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18
Q

Mild, moderate, or severe dehydration?

Extremities are cool, discolored, delayed cap refill (>3-4 sec).

A

Severe

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19
Q

Mild, moderate, or severe dehydration?

6-9% of body weight lost.

A

Moderate

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20
Q

5 causes of nonbilious vomitus.

A
  1. Infection
  2. Inflammation
  3. Metabolic
  4. Neurologic
  5. Psychologic
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21
Q

What is treatment for moderate dehydration?

A
  • 60-100 mL/kg over 4-6 hours for continuous diarrhea.
  • Replace ongoing losses mL for mL.
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22
Q

Mild, moderate, or severe dehydration?

Fontanel is normal.

23
Q

Mild, moderate, or severe dehydration?

Pulse is normal.

24
Q

Mild, moderate, or severe dehydration?

BP is low or undetectable.

25
Q

Mild, moderate, or severe dehydration?

Mucus membranes are dry.

26
Q

Mild, moderate, or severe dehydration?

Pulse is normal or rapid.

27
Q

Cause of bloody (coffee ground) vomitus.

28
Q

Mild, moderate, or severe dehydration?

Eyes are deeply sunken and absent tears.

29
Q

Mild, moderate, or severe dehydration?

Skin turgor is very poor.

30
Q

Mild, moderate, or severe dehydration?

Thirst is slightly increased.

31
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

Simple diarrhea

A

Isotonic/Isonatremic

32
Q

Mild, moderate, or severe dehydration?

Skin turgor is normal.

33
Q

What rehydration treatment might be considered outpatient?

A
  • 10 mL/kg for each episode of diarrhea or vomiting.
  • But for vomiting do it slowly.
34
Q

Mild, moderate, or severe dehydration?

Extremities are warm with normal cap refill.

35
Q

Mild, moderate, or severe dehydration?

Urine output is very decreased or absent.

36
Q

Mild, moderate, or severe dehydration?

Urine may appear normal.

37
Q

Cause of bilious vomitus.

A

Obstructive Lesions

38
Q

Mild, moderate, or severe dehydration?

Mucus membranes are moist.

39
Q

Mild, moderate, or severe dehydration?

Eyes are slightly sunken with decreased tears.

40
Q

Mild, moderate, or severe dehydration?

RR has a changing rate and pattern.

41
Q

Mild, moderate, or severe dehydration?

Up to 5% loss in body weight.

42
Q

Do breastfed babies continue to breastfeed when dehydrated?

A

Yes, but more frequently and for shorter periods.

43
Q

Mild, moderate, or severe dehydration?

BP is normal.

44
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

Massive loss of water and salt in stool. Oral replacement was with water alone.

A

Hypotonic/Hyponatremic

45
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

V/D with decreased water intake.

A

Hypertonic/Hypernatremic

46
Q

Mild, moderate, or severe dehydration?

LOC is alert, restless, thirsty.

47
Q

What is treatment for mild dehydration?

A

40-50 mL/kg over 4-6 hours

48
Q

When do you reintroduce bland solids during rehydration treatment?

A

After a minimum of 4-6 hours.

49
Q

Mild, moderate, or severe dehydration?

RR is normal or rapid.

50
Q

What liquids do you avoid in rehydration?

A
  • Plain water
  • Apple juice
  • Soda
  • Milk
  • Sports drinks
51
Q

Mild, moderate, or severe dehydration?

Fontanel is sunken.

A
  • Moderate
  • Severe
52
Q

Mild, moderate, or severe dehydration?

  • LOC is lethargic to comatose (infants and young children).
  • Often conscious, apprehensive (older children).
53
Q

How do you calculate the daily maintenance fluid requirements?

A
  • Child’s weight (kg)
  • 100 mL/kg 0-10 kg
  • 50 mL/kg 10-20 kg
  • 20 mL/kg for remaining kg
  • So, if a child weighs 23 kg, it would be: 1,000 + 500 + 60 = 1,560 mL/24 hours
54
Q

Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?

Fluid loss not balanced by fluid intake. Sodium and water losses in proportion.

A

Isotonic/Isonatremic