F&E Flashcards
What are signs of increased fluid requirements?
- Fever
- Vomiting, diarrhea
- High-output kidney failure
- Diabetes insipidus
- Diabetic ketoacidosis
- Burns
- Shock
- Tachypnea
- Radiant warmers
- Phototherapy
- Post-operative bowel surgery
What is the formula for a 24 hour fluid maintenance / daily fluid maintenance for a child?
- Calculate child’s weight in kg
- Allow 100 ml/kg for first 10 kg body weight
- Allow 50 ml/kg for second 10 kg body weight
- Allow 20 ml/kg for remaining body weight
Describe the 3 types of dehydration
- Isotonic - loss of water & salt
- Hypotonic - loss of salt in excess of water
- Hypertonic - loss of water in excess of salt
What are the physical signs of dehydration?
- Prolonged capillary refill
- Abnormal skin turgor
- Dry mucus membranes
- Absence of tears
- Ill appearance
- Abnormal respiratory pattern
- Sunken fontanel, eyeballs
What are some nursing interventions for patients who are dehydrated?
- Replace fluids –Oral/IV
- Weight daily
- Monitor Intake & output
- Monitor peripheral pulses
- Assess skin for coolness, mottled appearance
- Assess capillary refill
- Assess urinary output
- Assess vital signs
- Assess for changes in sensorium
What causes edema and what are some assessment findings of it?
Mechanisms of edema formation
- –Increased venous pressure
- –Capillary permeability
- –Diminished plasma proteins
- –Lymphatic obstruction
- –Tissue tension
- –Other factors
Assessment
- –Swelling
- –Increased weight
- –Increased abdominal girth
What are some signs and symptoms of acidosis?
- Lethargy
- Diminished mental capacity
- Delirium
- Stupor
- Coma
Acidosis -> PH goes down so everything goes down
What are some signs are symptoms of alkalosis?
- Over-excitability
- Nervousness
- Tingling sensations
- Tetany
- Seizures
What are some complications associated with acidosis?
Serum potassium
–Acidosis –> increased cell membrane permeability –> increased serum potassium
–Alkalosis –> decreased serum potassium
Serum calcium
–Chronic acidosis- bone resorption
Oxygen combination
–Acidosis- decreased affinity of hemoglobin for oxygen, less oxygen picked up in lungs but released easier in tissues
Blood flow
–Acidosis- constricts pulmonary vessels and dilates systemic vessels as well as cerebral vessels
–Alkalosis- constricts cerebral vessels
What are the clinical manifestations of dehydration?
–Tachycardia
–Dry skin, mucous membranes
–Sunken fontanel, eyes
–Loss of skin elasticity
–Capillary rate
–Change in vital signs
–Weight loss
What are the most common type of burns in infants toddlers?
Scald burns (burns from hot liquids)
What are the most common type of burns for older children?
Flame burns and smoke inhalation
Describe the early management of a burn injury in a child
- Identify and Treat Associated Injuries
- Assess Neurological Status
- Assess Airway
- Establish IV
- Foley Catheter
- Assess % TBSA Burn
- Nasogastric Tube
- Tetanus Toxoid and Immune Globulin
- Palpate peripheral pulses
- Vital signs
- Irrigate Chemical Burn
What are some characteristics of Second-Degree (Partial Thickness Burn)
Involves the epidermis and dermis
- Erythematous
- Blisters
- Painful
- Wound healing - 10-14 days with minimal scarring
What are some characteristics of Third-Degree (Full Thickness Burns)?
- Involves the epidermis, dermis and underlying subcutaneous tissues.
- Thick dry, leathery eschar
- Color of wound is red, gray, pearly white, yellow, brown, or black
- Painless wound
- Requires auto-graft to heal, will not heal on its own
