Fluid And Electrolytes Flashcards
TBW
Intercellular fluid + extra cellular fluid = total body water
Changes in TBW can be accurately and easily measured by using a scale, acute changes in patient’s weight will represent changes in the TBW
TBW with age
Preterm : 80-90 Newborn: 75-80 Infant: 75 Child 65-70 Teen: 60
What puts kids at risk for Dehydration problems
Increased extracellular fluid percentage
- h2o loss easy bc most of it ECF
increase basal metabolic rate
increase body surface area
- when lose heat more of body lose it
immature renal function
- don’t filter well
- dehydration makes worse
increase insensible fluid loss
- lose h2o with breathing (increase RR the more lose)
Risk for dehydration
Diarrhea vomiting decreased oral intake sustained high fever diabetic ketoacidosis extensive burns
Mild signs of dehydration
Slight thirst
Tears present
Cal refill > 2
Urine decreased
Moderate sign of dehydration
Pulse slight increase Slight tachypnea Irritable Thirsty Dry mucous membranes Decreased tears Normal to sunken anterior frontanel Slow cap refil 2-4 Oliguria
Severe dehydration
Very increase pulse Hyperpnea BP orthostatic or shock Lethargic Intense thirst Parched mucus membranes Cap refil > 4 Oliguria or anuria
Oral rehydration therapy
Should contain 50-75 mm sodium chloride and 13.5 g glucose
- pedialyte, infalyte and ricelyte
Mild - moderate require 50-100 ml/kg over 4hr
After reevaluate oral hydration may need to be continued if still dehydration
When rehydrate- can resume normal diet
What not to give for rehydration
Tap water Milk Undiluted fruit juice Soup Broth
How much water to give in 24 he period
100 ml/ kg for first 10kg
50ml/kg for next 10kg
20 ml/kg for remaining kg
Add total together and divide by 24 for per hour
Priority Assessments for Dehydration
Weight Heartrate Respiratory Rate Capillary Refill Skin Turgor/Elasticity Sunken Eyes
