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NUR 417: Peds Lecture > Exam 2 Fluid and Electrolytes > Flashcards

Exam 2 Fluid and Electrolytes Flashcards

1
Q

Dehydration : Developmental differences

A
  • Higher % of total body fluid
  • Immature renal/GI system
  • Higher % of ECF
  • Higher metabolic rate
  • Higher body surface area
  • Unable to communicate thirst
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2
Q

Dehydration: Early Signs

A

-Tachycardia

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3
Q

Dehydration: Most Reliable Signs

A

Weight: Same time. same day, same scale NAKED

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4
Q

Dehydration: Other Signs

A
  • Low BP
  • Decreased skin turgor
  • Decreased tear and saliva production
  • Dry mucus membranes
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5
Q

Bolus: Stable patient

A
  • Moderately dehydrated
  • RAPID Negative
  • Give bolus over 5-20 min, 20ml/kg
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6
Q

Bolus: Severe Patient

A
  • Severe Dehydration
  • RAPID +
  • Give bolus over 5-10min, 20ml/kg
  • Cardiac issues give 10-20 min, 5-10ml/kg
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7
Q

24hr Maintenance

A

First 10kg = _kg x 100 ml
Next 10 kg = _kg x 50 ml
Rest of the kg = _kg x 20 ml

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8
Q

Isotonic Dehydration

A
  • Na+ and water = loss
  • most common type of dehydration
  • loss is from ECF
  • No fluid shift
  • Due to = N/V/D, lack of oral intake when hot, excessive sweating, hemorrhage
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9
Q

Isotonic Dehydration S/S

A
  • Dry Skin/mucus membranes
  • Decreased skin turgor
  • Orthostatic hypotension
  • Thirsty
  • Dizzy
  • Constipated
  • Decreased urine
  • Decreased tears
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10
Q

Isotonic Dehydration Causes

A
  • Nausea, Vomiting
  • Lack of oral intake when hot
  • excessive sweating
  • hemorrhage
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11
Q

Isotonic Dehydration Lab Values

A
  • Serum Na+ Normal (130-150)
  • Serum Osmolality Normal
  • High Hematocrit
  • High (K+, Ca+)
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12
Q

Isotonic Dehydration Treatment

A

Isotonic fluids: NS

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13
Q

Hypotonic Dehydration

A
  • Serum Na+ low (<130)
  • Serum osmolality low
  • Fluid shifts from ECF to ICF (into cell - swelling)
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14
Q

Hypotonic Dehydration Causes

A
  • Rehydration with tap water only
  • Diuretics
  • Loss of gastric secretions
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15
Q

Hypotonic Dehydration Labs

A
  • Serum Na+ <130
  • Serum osmolality: Low <275
  • High Hematocrit
  • High (K+, Ca+)
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16
Q

Hypotonic Dehydration S/S

A
  • Confusion
  • Drowsiness/Dizziness
  • Decreased BP
  • Decreased urine
  • Decreased skin turgor
  • Thirsty
17
Q

Hypotonic Dehydration Treatment

A

NS

18
Q

Hypertonic Dehydration

A
  • Serum Na+ high >150
  • Serum osmolality high
  • Fluid shift from ICF to ECF (cells shrink)
19
Q

Hypertonic Dehydration Causes

A
  • excessive diarrhea
  • Increased osmotic diuretics (removes too much water)
  • Increased electrolytes/solutes PO
  • Increased Na in IVF
  • Increased NG Feeds
20
Q

Hypertonic Dehydration Labs

A
  • Serum Na+ high >150

- Serum osmolality high >295

21
Q

Hypertonic Dehydration S/S

A
  • Decreased altered mental status
  • Decreased skin turgor
  • Dry skin/mucus membranes
  • increased HR
  • Decreased BP
  • Confusion/drowsiness/Dizziness
  • Decreased tears
22
Q

Hypertonic Dehydration Treatment

A

-Give NS until hypotension is corrected, then give hypertonic fluids

23
Q

Normal Urine Output

A

Infants/Young kids
-1.5-2ml/kg/hr

Older Kids/Adolescents
-1ml/kg/hr

24
Q

Mild Dehydration

A
  • Normal HR, BP, RR
  • Normal anterior fontanelle
  • Normal Behavior
  • Normal mucus membraned
  • Cap refill >2 sec
  • Decreased urine output

Weight loss:

  • Infant 3-5%
  • Children 3-4%
25
Q

Moderate Dehydration

A
  • Normal BP to orthostatic
  • Normal anterior fontanelle
  • HR mildly increased
  • Slight tachypnea
  • Cap refill 2-4 sec
  • Decreased skin turgor
  • oliguria
  • irritable, dry mucus, thirsty

Weight loss:

  • Infant 6-9%
  • Child 6-8%
26
Q

Severe Dehydration

A
  • BP Orthostatic to shock
  • Sunken anterior fontanelle
  • Tachycardic
  • Hyperpnea (deep/rapid)
  • cap refill >4 sec
  • Skin tenting, cool, mottled
  • hyperirritable - lethargic
  • parched

Weight loss:

  • Infant >10%
  • child >10%
27
Q

Mild (5-6%) Rehydration Therapy

A

ORS 50ml/kg within 4-6hrs

28
Q

Moderate (7-9%) Rehydration Therapy

A

ORS: 100ml/kg within 4-6hrs

29
Q

Severe (>9%) Rehydration Therapy

A

IV Fluids: 20ml/kg over 5-10 min

-until pulse and mental status return to normal

30
Q

RAPID+

A 
R= rapid heart rate
A= altered color or altered capillary refill
P= Peeing nonexistent
I= inability to engage in the environment
D= decreased blood pressure
31
Q

Fluids used for Oral Rehydration

A
  • breast milk/formula
  • pedialyte
  • infalyte
  • rehydrolyte

NUR 417: Peds Lecture (12 decks)

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