Fluid & Electrolyte Imbalance Flashcards
When would there be increased fluid requirements?
- Fever (fluid loss through skin, tachypnea)
- Tachypnea (insensible loss and unable to feed)
- Radiant warmer (preemies)
- Vomiting and diarrhea
- Shock
- Burns
When would there be decreased fluid requirements?
- Heart failure
- Renal failure
- Increased ICP (fluids can cause H20 shifts to brain → cerebral edema)
How do you calculate daily maintenance fluid requirements?
Calculate child’s weight in kilograms:
- 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
What is 1kg in lbs?
1kg = 2.2 lbs
How much maintenance fluid (ml/hr) should be given for a child who weighs 32 kg?
- 1st 10 kg of body weight = 100ml x10kg = 1000ml (32kg-10kg=22kg)
- 2nd 10 kg of body weight = 50ml x 10kg = 500ml (22kg-10kg= 12 kg)
- Remaining = 20ml x 12kg = 240ml
1000 + 500 + 240 = 1740 ml/24 hr (72.5 = 73ml/hr)
How much maintenance fluid (ml/hr) should be given for a child who weighs 8.5 kg?
- 1st 10 kg 100 x 8.5 of body weight = 850
- No further calculations..Stop here
850 ml/24 hr=35.4 → 35ml/hr
What is Normal and Minimum Urine Output?
- Normal urine output: 1-2cc/kg/hour
- Minimum urine output = 1cc/kg/hour
What is Normal and Minimum Urine Output for a child who weighs 10kg?
- Normal urine output: 10cc-20cc per hour
- Minimal urine output per hour 10cc per hour
What are some S/S of Mild Dehydration (<5%)?
- Mental Status (LOC) = normal (alert)
- Heart Rate = normal
- Respiratory Rate = normal
- BP = normal
- Mucous membranes = normal (moist)
- Tears = present
- Anterior fontanel = normal
- Thirst = slight
- Capillary refill = normal (< 2 secs)
- Urinary Output = decreased urine
What are some S/S of Moderate Dehydration (5-9%)?
- Mental Status (LOC) = irritable
- Heart Rate = tachycardia
- Respiratory Rate = tachypnea
- BP = normal
- Mucous membranes = dry
- Tears = decreased
- Anterior fontanel = sunken
- Thirst = moderate
- Capillary refill = prolonged (2-4 secs)
- Urinary Output = oliguria (<1ml/kg/hr)
What are some S/S of Severe Dehydration (>10%)?
Mental Status (LOC) = lethargic, confused
Heart Rate = tachycardia
Respiratory Rate = hyperpnea (deep and rapid)
BP = hypotension
Mucous membranes = parched
Tears = absent
Anterior fontanel = deeply sunken
Thirst = intense
Capillary refill = prolonged (> 4 secs)
Urinary Output = anuria (absence of urine)
What is Shock?
- Shock is an acute life-threatening condition
- Circulatory failure results in inadequate perfusion and oxygen deprivation of the tissues → organ failure
- Most common types of shock in children
- Hypovolemic
- Septic
What are some S/S of Shock?
- Mental Status (LOC) = lethargic, unresponsive
- Heart rate = bradycardia
- Respiratory rate = tachypnea
- Blood pressure = hypotension (late sign)
- Capillary Refill = prolonged (3-4 secs)
- Peripheral pulses = decreased, weak
- Skin = pale, cool
- Urine output = anuria
Describe Hypovolemic Shock?
- Most common cause of shock in pediatric patient
- Reduction in circulating blood volume r/t blood loss and extracellular fluid (ECF) loss
- Trauma
- Burns (3rd spacing)
- Gastroenteritis- vomiting/diarrhea
Describe how Hypovolemic Shock occurs?
- Decreased Blood / Fluid Volume
- Decreased Cardiac Output
- Decreased O2 and tissue perfusion
- Organ failure
- Death
idk if we need to know this
