Fluid and Electrolytes- Dehydration in PEDS Flashcards
What is the decrease in intravascular, interstitial and/or ICF in the body?
Fluid volume deficit
Loss of fluid alone is what?
Dehydration
What may exist alone or in combo w/ acid base imbalances and can occur slowly or rapidly?
Fluid volume deficit
How do infants/younger children differ from older children/adults in dehydration?
More vulnerable to alterations in fluid and electrolyte balance
Infants/younger children differ from older children/adults by disturbances occurring more ____ and _______.
Often; quicker
Infants/younger children differ from older children/adults by having ______ adjustments to alterations.
Slower
Infants/younger children differ from older children/adults by having greater _____ ______ and _____ in relation to size.
Fluid intake and output
Infants/younger children differ from older children/adults by length of ____ _____ being greater in an infant (larger surface for absorption).
Small intestine
Infants and younger children have a ECF that is?
Larger and constitutes greater proportion of body wt.
What are immature and inefficient in an infant?
Kidneys
Infants have a high daily what w/ little reserve?
Fluid requirement
The body surface of an infant/young child is what?
Greater
The basal metabolic rate (BMR) of an infant/young child is what?
Higher
What do infants/young children lose more of bc they can’t old on to it very well?
Fluid
What can’t infants/young children concentrate well?
Water
Infants/young children are @ risk for what bc they can’t handle solid loads as well?
Acid base imbalance
Infants/young children have more what bc of a warmer, increase in respirations and fever?
Insensible fluid loss
Infants/young children can’t handle what well bc it doesn’t have electrolytes and nutrients?
Solute free liquid like water
What factors affect fluid and electrolytes in infants/young children?
Age, gender, body size, environmental temps, and lifestyle
Total output>total intake is what? And can include insensible losses from a # of diseases?
Dehydration
Why is a stomach virus susceptible to dehydration and infection?
Bc of diarrhea
What type of dehydration is it when primary form in children electrolyte and water deficits are equal?
Isotonic
What type of dehydration is it when electrolyte deficits are greater than water deficits?
Hypotonic
What type of dehydration is it when water loss is greater than electrolyte loss?
Hypertonic
Isotonic dehydration can cause signs of what?
Hypovolemic shock
In hypotonic dehydration why are symptoms more severe?
ECF is more concentrated
Why is hypertonic dehydration the most dangerous type?
ECF higher (high NG loads)
What are the 3 simple measurements used for dehydration?
Weight, VS, and Intake and output (wet diapers)
What are some nursing assessments to assess for dehydration?
General appearance, wt., LOC, VS, I/O, Skin turgor, mucous membranes, fontanels, extremities (cap refill)
Each kg of wt is equal to how many liters?
1
What’s a good indicator for fluid volume deficit?
Rapid wt. loss
How do you calculate the percentage of severity of clinical dehydration?
Subtract child’s current wt. from original wt.
divide loss by original wt and multiply by 100 to get into a percentage
How much percent is mild severity of dehydration?
Less than 5% (40-50ml/kg)
How much percent is moderate severity of dehydration?
6-9% (60-90ml/kg)
How much percent is severe severity of dehydration?
> 10% (greater or equal to 100ml/kg)
Even though mild dehydration is hard to detect what’s one way to detect it?
Infants irritable, older children thirsty
Infants may have restlessness and irritability, skin turgor diminished, dark and decrease amount of urine, elevated pulse rate, low BP, or normal children are often lethargic and sleepy all help to detect what?
Moderate dehydration
Increased lethargy or non responsive, markedly decrease in BP, rapid pulse, poor skin turgor, dry mucous membranes, seizure activity, and markedly decreased urinary output all help to detect what?
Severe dehydration
When calculating daily maintenance of fluid requirements 10kg is equal to how many ml’s?
100ml
When calculating daily maintenance of fluid requirements 2nd 10kg is equal to how many ml’s?
50ml
When calculating daily maintenance of fluid requirements remainder of kg above 20kg is equal to how many ml’s?
20ml
What clinical therapies are used for dehydration?
Accurate degree of dehydration, oral rehydration, and IV fluids
What is a more effective, safer, less painful and less costly than IV hydration?
Oral rehydration therapy
What is not a contraindication in oral rehydration therapy?
Vomiting
Oral rehydration therapy enhances and promotes reabsorption of what?
Sodium and water
What greatly decreases vomiting, volume loss from diarrhea and duration of illness?
Oral rehydration therapy
What is one type of oral rehydration therapy?
Pedialyte
When should you use pedialyte or other ORT?
At frequent intervals in small amounts
When should you admin parenteral therapy?
If fluid deficit is severe, unable to take fluids or has hypertonic dehydration
What is contraindicated during parenteral therapy bc of the risk of cerebral edema?
Rapid fluid replacement
What should you avoid during parenteral therapy until renal function is verified?
Potassium
