F&E

Question 1

Fluid Maintenacne

First 10 kg (Weight < 10 kg)
=
Next 10 kg (weight between 10 & 20 kg)
=
>20 kg
=

Answer 1

ml/kg/day

100
/
50
/
20

Question 2

Fever-each 1 degree over 99° F =

Answer 2

increases maintenance

fluid requirements by 7ml/kg/day

Question 3

8 Factors Increasing Maintenance Fluid

Answer 3

Tachypnea

Increased temperature of the environment

Burns

Ongoing losses-diarrhea, vomiting, NG tube output, high output kidney failure.

Diabetic ketoacidosis, diabetes insipidus

Shock

Radiant warmer, phototherapy
Postoperative bowel surgery

Fever

Question 4

Factors Decreasing Maintenance Fluid Requirements

Answer 4

Skin: Mist tent, incubator, swamp bed (premature infants)

Lungs: Humidified ventilator

Renal: Oliguria, anuria

Misc.: Hypothyroidism

Congestive Heart Failure

Increased intracranial pressure

Syndrome of inappropriate antidiuretic hormone (SIADH)

Question 5

Nursing Care of Fluid Excess

Answer 5

Limit intake
Diuretics
Monitor vital signs
Monitor neurologic status
Seizure precautions

Question 6

3 Types of Dehydration

Answer 6

Isotonic
Electrolytes = water
Serum Na 135-145 mEq/L
~80% of all dehydration patients

Hypertonic
Water loss >Electrolyte loss
Serum Na > 145 mEq/L
~15% of all dehydration patients

Hypotonic
Electrolyte loss > Water loss
Serum Na < 135 mEq/L
~5% of all dehydration patients

Question 7

Clinical Assessment of Dehydration:

Mild
Moderate
Severe

Answer 7

See Chart

Question 8

Signs of Mild dehydration

Answer 8

• Increase thirst

- Slightly dry mucus membranes

Question 9

Signs of Moderate dehydration

Answer 9

-Loss of skin turgor, dry mucus membranes, sunken eyes and fontanels

Question 10

Signs of Severe Dehydration

Answer 10

Signs of mod. Dehydration + 1 of following: rapid pulse, cyanosis, rapid breathing, lethargy, coma

Question 11

Normal urine output in children

Answer 11

1-2 ml/Kg/hr