Children and Dehydration Flashcards
Why is fluid and electrolyte balance important?
- Maintaining body fluids and electrolytes within a very narrow normal limit is necessary to maintain homeostasis in the body
- Many illnesses can cause imbalances in a child or infant’s fluid and electrolyte levels
- These imbalances can happen very quickly in children/infants and be quite critical and even fatal
- Children are mostly made of water, have a lower reserve than adults when vomiting or have diarrhea
What are the different body fluid compartments?
- The main intravascular fluid in mammals is blood, a complex mixture with elements of a suspension (blood cells), colloid (globulins), and solutes (glucose and ions).
- Interstitial fluid is the body fluid between blood vessels and cells, containing nutrients from capillaries by diffusion and holding waste products discharged out by cells due to metabolism.
- Transcellular fluid is the portion of total body water contained within the epithelial-lined spaces. It is the smallest component of extracellular fluid, which also includes interstitial fluid and plasma.
- Transcellular fluids: synovial fluids, peritoneal fluid, pericardial, intraocular fluid, cerebrospinal fluid
What are the functions of body water?
- Transport Medium
- Body Temperature Regulation
- Lubrication
- Assists with Digestion
What is the percentage of body weight that is composed of water?
Term neonate: 75%, ECF=45%, ICF=35%
6 months: 65%, ECF=25%, ICF= 40%
2 years: 60%, ECF=20%, ICF=40%
What are some of the fluid issues in the pediatric population?
1) Body Surface Area
2) Basal Metabolic Rate: Kids breathe faster, HR beat faster, therefore they lose water faster
3) Kidney Function: immature kidneys, usually have very clear urine, uric acid crystals
4) Fluid Requirements: don’t drink because they tire quickly
What is maintenance fluid?
the amount of fluid the body needs to replace usual daily losses from the respiratory tract, the skin, and the urinary and GI tract
How can you calculate maintenance fluid requirements?
Daily:
100mL/kg for the first 10kg
+50mL/kg for the second 10kg
+20mL/kg for each kg >20kg = mL/day
Hourly:
4mL/kg x first 10kg
+ 2mL/kg x second 10kg
+ 1mL/kg x for each kg >20kg = mL/hr
What are some conditions that modify fluid requirements?
Increase fluid intake
- Fever
- Vomiting
- Diarrhea
- Diabetes Insipidus
- Burns
- Tachypnea
- Chemo
Decrease fluid intake
- Meningitis
- Congestive Heart Failure
- Renal Failure
- SIADH
- Fluid overload
What is dehydration? What are the three types?
- Common body fluid disturbance in infants and children
- Total output of fluid exceeds the total intake
- Can result from a lack of oral intake, however, in infants and children most often results from abnormal losses
Classified into 3 categories: - Isotonic
- Hypotonic
- Hypertonic
Describe isotonic dehydration
Sodium loss= water loss
Serum sodium is normal
Most common form of dehydration in infants/children
What are the major causes of isotonic dehydration?
3 major causes:
Fluid loss
Reduced fluid intake
Fluid shift out of the vasculature (3rd spacing)
What are the signs and symptoms of isotonic dehyrdration?
S&S: hypotension, tachycardia, thirst, flattened neck veins, sunken eyes, dry mucous membranes, decreased skin turgor, acute weight loss, decreased urine output, prolonged cap. refill, confusion/changes in LOC
What is hypotonic dehydration? What are the causes? Signs and symptoms?
Sodium loss > water loss Serum sodium < 130 mmol/L Causes: Excessive sodium loss Increased water gain S&S: lethargy, confusion, headache, seizures, coma
What is hypertonic dehydration? What are the causes? Signs and symptoms?
Sodium loss < water loss Serum sodium > 150 mmol/L Most dangerous type of dehydration Causes: Excessive free water loss Sodium excess S&S: agitation, restlessness, hyperirritability, decreased LOC, seizures, coma
How do you calculate fluid volume deficit?
Fluid Volume Deficit (L)= Weight(kg) X %Dehydration
What is the fluid deficit for an 8kg infant with 10% dehydration?
8(kg) x 10% = 0.8L fluid deficit
