Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

peds > ch 23 fluid and electrolytes > Flashcards

ch 23 fluid and electrolytes Flashcards

1
Q

differences in infants related to body surface area

A

-body surface area is larger
-GI tract is longer
-larger quantities fluid lost through skin and GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

differences in infants related to metabolic rate

A

-metabolic rate higher
-greater production metabolic wastes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

differences in infants related to kidney function

A

-kidneys immature
-unable to concentrate or dilute urine
-unable to conserve or secrete sodium
-unable to acidify urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

water balance differences in infants/children

A

-greater need for water
-greater content extracellular Na and Cl
-more vulnerable to alterations in fluid electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how much increased water is needed to replace insensible water loss for each 1 degree rise in temp above 99F

A

7 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what situations result in increased water requirements

A

-fever
-tachypnea
-radiant warmer
-V/D
-DI
-DKA
-shock
-burns
-post-op bowel surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what situations result in decreased water requirements

A

-heart failure
-increased ICP
-renal failure (oliguric)
-SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how to calculate child’s daily fluid requirements based off weight in kg

A

-for 1st 10kg body weight: 100 mL/kg
-for 2nd 10 kg body weight: 50 mL/kg
-for remaining body weight: 20 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

greatest threat to life in isotonic dehydration

A

shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

S+S isotonic dehydration

A

-electrolyte and water deficits balanced (H2O loss = NaCl loss)
-major losses from ECF (decreased plasma volume affects skin, kidneys, muscles)
-no osmotic force
-*sodium within normal limits (130-150)
-most common dehydration in kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S+S hypotonic dehydration

A

-electrolyte loss exceeds water loss
-ICF more concentrated, fluid shifts from ECF to ICF, increases ECF loss
-physical signs more severe
-*Na<130
-shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

S+S hypertonic dehydration

A

-water loss greater than electrolyte loss
-fluid shift from ICF to ECF
-most dangerous for kids
-seizures (can cause permanent damage)
-*Na>150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why is rapid fluid replacement contraindicated in Tx of hypertonic dehydration

A

water intoxication
cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

general S+S dehydration

A

-variable temp
-irritable
-dry skin and mucous membranes
-lethargic, fatigue
-poor skin turgor
-altered LOC
-poor perfusion (prolonged cap refill)
-weight loss
-decreased urine output
-sunken fontanels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

degrees of dehydration (3) according to mL/kg

A

mild: <50 mL/kg (5% deficit)
moderate: 50-90 mL/kg (10% deficit)
severe: >100 mL/kg (15% deficit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

earliest sign dehydration

A

tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what S+S are good predictors of dehydration greater than 5% deficit
(2+ signs)

A

-cap refill >2 secs
-absence of tears
-dry mucous membranes
-ill general appearance
-decreased urinary output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

best 3 individual examination signs for assessing dehydration

A

-prolonged cap refill (>2 secs)
-abnormal skin turgor
-abnormal resp pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

oral rehydration Tx for dehydration

A

rapid fluid replacement over 4-6 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

parenteral rehydration Tx for dehydration

A

-initially: replace ECF volume
-isotonic solution
-20-30 mg/kg IV bolus over 20 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

isotonic fluids given for dehydration

A

-0.9% NS
-LR
-D5 .25NS
*NO DEXTROSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

electrolyte Tx for dehydration

A

-sodium bicarb (to combat acidosis)
-potassium replacement (*don’t give until child voids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

normal urine specific gravity
-child
-infant

A

child: 1.016-1.022
infant: 1.001-1.020

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

possible complications of diarrhea

A

-dehydration
-electrolyte imbalance
-metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

infectious causes acute diarrhea

A

-rotavirus
-c diff
-e coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

causes watery explosive diarrhea

A

sugar intolerance

27
Q

causes greasy bulky stools

A

fat malabsorption

28
Q

causes of neutrophils or RBCs in diarrhea

A

bacterial infection
irritable bowel disease

29
Q

causes of eosinophils in diarrhea

A

protein intolerance
parasitic infection

30
Q

when would you get a stool specimen for diarrhea

A

lasted longer than 3-4 days
bloody stool
mucus in stool

31
Q

causes of stool pH<6

A

carbohydrate malabsorption
lactose deficiency

32
Q

4 main types shock

A

-hypovolemic
-cardiogenic
-distributive shock
-obstructive shock

33
Q

causes hypovolemic shock

A

reduction in circulating blood volume:
-trauma
-bleeding
-burns
-diarrhea

34
Q

causes cardiogenic shock

A

decreased cardiac output:
-following cardiac surgery

35
Q

causes distributive shock

A

from vascular abnormality:
-neurogenic shock
-anaphylactic shock
-septic shock

36
Q

causes obstructive shock

A

-cardiac tamponade
-tension pneumothorax
*may resemble hypovolemic shock

37
Q

S+S hypovolemic shock

A

-narrow pulse pressure
-tachycardia
-weak peripheral pulses
-pale, cool skin
-delayed cap refill >2 secs
-decreased urine output
-irritable LOC

38
Q

S+S distributive shock

A

-possible crackles
-tachycardia
-bounding or weak peripheral pulses
-warm or cool skin
-lethargic LOC

39
Q

S+S cardiogenic shock

A

-labored resps
-crackles and grunting
-tachycardia
-hypoTN
-narrow pulse pressure
-weak peripheral pulses
-cool pale skin
-delayed cap refill > 2 secs

40
Q

S+S obstructive shock

A

-labored resps
-crackles and grunting
-hypoTN
-narrow pulse pressure

41
Q

3 classifications (severities) shock

A

-compensated
-hypotensive (decompensated)
-irreversible (terminal)

42
Q

S+S compensated severity of shock

A

-irritable
-normal BP
-narrow pulse pressure
-tachycardia
-thirst
-pallor
-diminished urinary output

43
Q

S+S hypotensive (decompensated) severity of shock

A

-tachypnea
-moderate metabolic acidosis
-oliguria
-cool pale extremities
-cap refill >3 secs
-hypoTN (*late sign)

44
Q

Tx shock

A

-oxygen and ventilation
-fluids
-vasopressor

45
Q

Tx septic shock

A

prompt admin Abx

46
Q

3 stages septic shock

A

-early
-normodynamic (cool or hyperdynamic decompensated)
-hypodynamic (cold)

47
Q

S+S early stage septic shock

A

-chills
-fever
-warm flushed skin
-normal BP and urinary output

48
Q

S+S normodynamic (cool or hyperdynamic decompensated) stage of septic shock

A

-cool skin
-urinary output starting to diminish
-normal BP and pulses

49
Q

S+S hypodynamic (cold) stage of septic shock

A

-cardiovascular function deteriorating
-cold extremities
-weak pulses
-hypoTN
-oliguria or anuria
-lethargic or comatose
-multiorgan failure

50
Q

S+S anaphylaxis

A

-headaches
-anxiety
-stridor
-SOB
-abdominal pain
-itchiness
-swelling
-tachycardia
-hypoTN

51
Q

S+S 1st degree burn (partial thickness)

A

-epidermis intact, no blisters
-erythema (skin blanches with pressure)
-painful
-discomfort 2-3 days
-healing 3-7 days

52
Q

S+S 2nd degree burn (partial thickness)

A

-wet, shiny, weeping surface
-blisters
-wound blanches with pressure
-painful and very sensitive to touch and air
-superficial partial thickness heals in <21 days
-deep partial thickness heals in >21 days

53
Q

S+S 3rd degree burn (full thickness)

A

-variable color (deep red, brown, white, black)
-dry surface
-blood vessels visible
-no blanching
-insensate
-requires autografting

54
Q

S+S 4th degree burn (full thickness)

A

-color variable
-charring in deepest areas
-extremity movement limited
-insensate
-amputation likely
-requires autografting

55
Q

effects of burns on cardiovascular system

A

-drop in cardiac output (shock)
-cardiac output returns to normal within 1-2 days
-edema

56
Q

effects of burns on renal system

A

-increased fluid requirements
-elevated BUN and creatinine
-hematuria
-high risk kidney failure

57
Q

effects of burns on GI system

A

-decreased blood flow to GI
-atrophy of GI tract
-increased metabolic rate
-elevated glucose levels
-elevated body temp
-potential gut barrier dysfunction (could lead to sepsis)

58
Q

possible pulmonary complications of burns

A

-inhalation injury
-aspiration of GI contents
-bacterial pneumonia
-pulmonary edema
-pulmonary emboli

59
Q

possible GI complications of burns

A

-feeding intolerance
-ulcers
-bleeding
-potential GI tract barrier loss

60
Q

possible complications of burns

A

-GI tract
-pulmonary
-wound sepsis
-CNS (burn encephalopathy)

61
Q

emergency care Tx of burns

A

-stop burning process
-assess condition
-cover burn
-transport
-provide reassurance

62
Q

Tx minor burns

A

-clean with mild soap and water
-debride
-antimicrobial ointment
-cover with light gauze
-sometimes: silver wound dressing

63
Q

Tx major burns

A

-adequate airway
-fluid replacement
-nutrition support
-meds for pain
-burn wound management

64
Q

what is the parkland calculation formula for admin of fluids for dehydration

A

-for LR: 4 mL x BSA% x weight(kg)
-give half of solution for 8 hrs
-give other half solution for next 16 hrs

peds (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions