9: Peds N/V Flashcards
Mild, moderate, or severe dehydration?
RR is normal.
Mild
Mild, moderate, or severe dehydration?
Thirst is moderately increased.
Moderate
Mild, moderate, or severe dehydration?
Tachycardia or bradycardia.
Severe
Mild, moderate, or severe dehydration?
Eyes are normal.
Mild
Mild, moderate, or severe dehydration?
LOC is irritable or lethargic (infants and very young children). Alert, thirsty, restless (older children).
Moderate
In dehydration, what is the initial period of bowel rest?
1-2 hours
Mild, moderate, or severe dehydration?
- Urine output is decreased (<1 mL/kg/hr).
- Dark color.
- Increased specific gravity.
Moderate
Mild, moderate, or severe dehydration?
Mucus membranes are parched.
Severe
Mild, moderate, or severe dehydration?
10% or more body weight loss.
Severe
Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?
Greater water loss than salt loss.
Hypertonic/Hypernatremic
Mild, moderate, or severe dehydration?
Thirst is greatly increased unless lethargic.
Severe
Mild, moderate, or severe dehydration?
Delayed cap refill (>2 sec).
Moderate
What are 5 risk factors for dehydration in N/V?
- Increased extracellular fluid percentage and an increase in body water compared to adults.
- Increased basal metabolic rate.
- Increased body surface area.
- Immature renal function.
- Increase insensible fluid loss through temperature elevation.
Mild, moderate, or severe dehydration?
Skin turgor is poor.
Moderate
Mild, moderate, or severe dehydration?
BP is normal or low. Postural hypotension (older children).
Moderate
What is treatment for severe dehydration?
- NS or LR solution.
- 20-40 mL/kg bolus.
- Repeat as needed.
- Begin oral therapy when more alert.
Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?
Sodium loss greater than water loss.
Hypotonic/Hyponatremic
Mild, moderate, or severe dehydration?
Extremities are cool, discolored, delayed cap refill (>3-4 sec).
Severe
Mild, moderate, or severe dehydration?
6-9% of body weight lost.
Moderate
5 causes of nonbilious vomitus.
- Infection
- Inflammation
- Metabolic
- Neurologic
- Psychologic
What is treatment for moderate dehydration?
- 60-100 mL/kg over 4-6 hours for continuous diarrhea.
- Replace ongoing losses mL for mL.
Mild, moderate, or severe dehydration?
Fontanel is normal.
Mild
Mild, moderate, or severe dehydration?
Pulse is normal.
Mild
Mild, moderate, or severe dehydration?
BP is low or undetectable.
Severe
Mild, moderate, or severe dehydration?
Mucus membranes are dry.
Moderate
Mild, moderate, or severe dehydration?
Pulse is normal or rapid.
Moderate
Cause of bloody (coffee ground) vomitus.
GI Bleed
Mild, moderate, or severe dehydration?
Eyes are deeply sunken and absent tears.
Severe
Mild, moderate, or severe dehydration?
Skin turgor is very poor.
Severe
Mild, moderate, or severe dehydration?
Thirst is slightly increased.
Mild
Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?
Simple diarrhea
Isotonic/Isonatremic
Mild, moderate, or severe dehydration?
Skin turgor is normal.
Mild
What rehydration treatment might be considered outpatient?
- 10 mL/kg for each episode of diarrhea or vomiting.
- But for vomiting do it slowly.
Mild, moderate, or severe dehydration?
Extremities are warm with normal cap refill.
Mild
Mild, moderate, or severe dehydration?
Urine output is very decreased or absent.
Severe
Mild, moderate, or severe dehydration?
Urine may appear normal.
Mild
Cause of bilious vomitus.
Obstructive Lesions
Mild, moderate, or severe dehydration?
Mucus membranes are moist.
Mild
Mild, moderate, or severe dehydration?
Eyes are slightly sunken with decreased tears.
Moderate
Mild, moderate, or severe dehydration?
RR has a changing rate and pattern.
Severe
Mild, moderate, or severe dehydration?
Up to 5% loss in body weight.
Mild
Do breastfed babies continue to breastfeed when dehydrated?
Yes, but more frequently and for shorter periods.
Mild, moderate, or severe dehydration?
BP is normal.
Mild
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.
Hypotonic/Hyponatremic
Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?
V/D with decreased water intake.
Hypertonic/Hypernatremic
Mild, moderate, or severe dehydration?
LOC is alert, restless, thirsty.
Mild
What is treatment for mild dehydration?
40-50 mL/kg over 4-6 hours
When do you reintroduce bland solids during rehydration treatment?
After a minimum of 4-6 hours.
Mild, moderate, or severe dehydration?
RR is normal or rapid.
Moderate
What liquids do you avoid in rehydration?
- Plain water
- Apple juice
- Soda
- Milk
- Sports drinks
Mild, moderate, or severe dehydration?
Fontanel is sunken.
- Moderate
- Severe
Mild, moderate, or severe dehydration?
- LOC is lethargic to comatose (infants and young children).
- Often conscious, apprehensive (older children).
Severe
How do you calculate the daily maintenance fluid requirements?
- 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
Which type of dehydration (isotonic/isonatremic, hypotonic/hyponatremic, or hypertonic/hypernatremic)?
Fluid loss not balanced by fluid intake. Sodium and water losses in proportion.
Isotonic/Isonatremic