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Pediatrics > Alterations in fluid, electrolyte, + pH > Flashcards

Alterations in fluid, electrolyte, + pH Flashcards

1
Q

extracellular fluid volume excess

A

too much fluid in vascular + interstitial compartment

-w normal serum Na concentration

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2
Q

possible cause of extracellular fluid volume excess

A

excessive IV fluids

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3
Q

hypernatremia

A

loss of water > loss of Na
or
gain of Na > water

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4
Q

hypernatremia

can be from…

A
  • dehydration of breastfed newborn esp at 2-3 day mark
  • decr LOC, confusn, lethargy, coma, seizures
  • low UOP except in cases of DI
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5
Q

hypernatremia

treatment

A

treated slowly

w isotonic first then hypotonic

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6
Q

hypernatremia

loss of more water than sodium can be caused by…

A
  • deficient breastfeeding intake w norm output
  • diarrhea/vomiting w/o fluid replacmt
  • DI
  • excessv sweating w/o fluid replacmt
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7
Q

hypernatremia

gain of more Na than water can be caused by…

A
  • inability to comunicate thirst
  • limited access to water
  • IV HYPERtonic soln
  • improper formular prep
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8
Q

water deprivation can lead to ____ and may possibly be caused by ___

A

hypernatremia

munchausen syndrome by proxy or neglect

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9
Q

to prevent hypernatremia…

A

extra fluids during hot weather, vomit, diarrhea

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10
Q

hyponatremia

A

decr osmolality of blood

-fr dilatn of body fluids

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11
Q

hyponatremia

causes

A
  • forced intake of water
  • *dilute formula
  • excessive swallowing of swimming pool water
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12
Q

hyponatremia

manifestations

A 
lethargy
decorticate posturing
coma
anorexia
n/v
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13
Q

hyponatremia

treatment

A

treated slowly w isotonic fluids

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14
Q

hyperkalemia can be caused by anything that…

A

kills a lot of cells

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15
Q

hyperkalemia

manifestations

A

-muscle dysfunction
-hyperactivity of smooth muscles in GI tract
»»cause cramping/diarrhea
-cardiac arrhythmias

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16
Q

hyperkalemia is removed thru…

A

dialysis, diuretics, + kayexalate

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17
Q

HYPER kalemia

nursing mgmt

A
  • check UO (should be 1-2 mL/kg/hr)

- turn IV soln to mix K

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18
Q

hypokalemia can be caused by…

A
  • *incr K thru GI tract is most common in kids)
  • *fad diets
  • *nasogastric suctioning can cause K loss
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19
Q

HYPO kalemia

manifestations

A

slowed GI: ab distentn, constipatn, paralytic ileus

gen muscle weaknss

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20
Q

when administering K via IV,…

A

may need to dilute or slow down

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21
Q

Calcium is needed for…

A
  • muscle/nerve function
  • hormones
  • bone formation
  • strength
  • clotting factors
22
Q

Ca requires ___ for max efficiency

A

vitamin D

23
Q

more calcium during childhood reduces the risk of…

A

osteoporosis

24
Q

infants w ___ are at risk for HYPERcalcemia bc…

A

low birth wt;

inadequate bone phosphorous

25
Q

most common cause of hyper-calcemia

A

shift of Ca fr bones to plasma

-fr tumor or hyperparathyroidism

26
Q

hyper-calcemia

nonspecific symptoms

A
  • fatigue
  • weakness
  • confusion
  • lethargy
  • decr attention span
27
Q

hyper-calcemia

severe symptoms

A
  • cardiac arrhythmias

- death

28
Q

hyper-calcemia

treatments

A

hydration

  • avoid vit D supplements
  • avoid Ca rich food
  • avoid TUMS
29
Q

hypo-calcemia

etiology/common causes

A

-children w chronic generalized malnutritoin
-fem adolescents trying to lose wt often drop foods high in Ca
»»causes premature bone loss, inadequate bone, risk for osteoporosis
-vitamin D deficienct

30
Q

hypo-calcemia

nursing mgmt

A 
assess for...
-diet
-fat/muscle wasting
-muscle cramps
-stiffness
-clumsiness
-incr excitability
>>CHVOSTEK SIGN
>>TROUSSEAU SIGN
31
Q

hypo-calcemia should dirnk…

A

3 glasses of nonfat milk per day

32
Q

most common cause of hypermagnesemia in childten

A

impaired renal functioning leading to decr Mg excretion

33
Q

possible cause of hypermagnesemia in newborn

A

MgSulfate in moms to treat eclampsia before birth

34
Q

hypermagnesemia

education

A

avoid milk of magnesia + antacids w magnesium

35
Q

hypomagnesemia

2 routes of loss

A

GI loss: diarrhea, malabsorption, small bowel bypass surgery

Renal loss: diuretics, genetic disorder, diabetic ketoacidosis

36
Q

hypomagnesemia

manifestations

A
  • hyperactive reflex
  • muscle cramps
  • cardiac arrhythmias
  • trousseau + chvostek signs
37
Q

hypo-Mg can cause…

A

hypo-Ca

38
Q

Respiratory Acidosis is caused by

A

accumulation of CO2 in blood

**any factor that interferes w ability of lungs to excrete CO2 can cause respiratory acidosis

39
Q

Respiratory Acidosis

education

A

encourage deep breathing in younger children

  • use pinwheel
  • blow bubbles thru water
  • blow scraps of paper across table
40
Q

respiratory acidosis

factors affecting the lungs

A
  • epiglottitis
  • cystic fibrosis
  • pulmonary embolism
41
Q

respiratory acidosis

factors affecting the neuromuscular pump

A
  • pneumothorax or hemothorax
  • hypokalemic muscle weakness
  • congenital diaphragmatic hernia
42
Q

respiratory acidosis

factors affecting the central control of respiration

A
  • sedative overdose

- general anesthesia

43
Q

respiratory alkalosis

common causes

A
  • hyperventilation
  • anxiety
  • fear
  • pain
44
Q

if respiratory alkalosis persists for days,

A

kidneys compensate by
>retaining acid
>excreting bicarbonate

45
Q

respiratory alkalosis

signs

A
  • light headed feeling
  • tingling
  • numbness to fingers or toes
  • tachypnea
46
Q

metabolic acidosis

A

excess of any acid other than carbonic acid

47
Q

metabolic acidosis

causes

A

-eat/drink substance w acid like aspirin
-cells make abnorm amt of acid
»>ketoacidosis, starvation fr anorexia/bulimia

48
Q

metabolic acidosis causes respiratory compensation called..

A

kussmaul respiration

49
Q

metabolic alkalosis

A

too few metab acids

50
Q

metabolic alkalosis

causes

A
  • excessive intake of bicarb antacids or baking soda
  • citrate metabolized into bicarb in blood transfusn
  • lose of acid thru severe vomiting, continuous gastric suction

Pediatrics (51 decks)

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