Fluid & Electrolytes PowerPoint Flashcards
unable to produce tears until
6 weeks
3 months
infants are dependent on who for provide fluids for them
dependent
infant GI tract has what proportional surface area than adults
GI
infants have a high risk for
dehydration
kidneys cannot fully conserve fluids and electrolytes until child
2 years
newborn how much greater daily water need/kg
4-5x
increased or respiratory rate
increased
increased or decreased metabolic demands
increased
what is the largest part of body
largest
high metabolic rate + decreased fluid reserve =
increased risk for imbalance
throw up goes to what acid base imbalance
alkaloid
- diarrhea acid
intracellular accounts for how much
2/3
extracellular accounts for how much
1/3
difussion
movement from greater to lesser concentration
microtubules
immature so they have difficulty in maintaining the sodium & calcium, increase risk for acidosis
children have higher or lower metabolic rate
higher
vascular volume
cap refil
character of pulse
BP *late sign
central venous pressure
tenseness of fontanelle
I & O
tears
urine specific gravity
mucous membrane
skin turgor
presence of absence of edema
LOC
1kg =
1L
normal U/O children
0.5 to 1mL/kg/hr
normal U/O infant
2mL/kg/hr
3 main ways to become dehydration
decreased intake
decreased output
translocation
common cause of dehydration
diarrhea
vomiting
gastroenteritis
pharyngitis
febrile illness
DKA
DI
burns
isotonic dehydration
sodium and water are lost in proportion to each other and therefore serum sodium is normal
hypotonic dehydration
sodium loss is greater than water loss so serum sodium levels are low
fluid shifts from the ECF to ICF to attempt to correct the loss causing worsening ECF dehydration
hypertonic dehydration
water loss is greater than sodium loss so serum sodium levels are high
fluid moves from the ICF to ECF
Thus the ECF remains normal and s/s of dehydration
mild dehydration s/s
slightly decreased urine output
slightly increased thirst
slightly dry mucous membranes
slightly elevated heart rate
mild dehydration amount
40-50mL/kg
moderate dehydration
decreased urine output
moderately increased thirst
dry mucous membrane
elevated heart rate
decreased skin turgor
sunken eyes
sunken fontanel
moderate dehydration amount
60-90mL/kg
severe dehydration s/s
markedly decreased or absent urine output
greatly increased thirst
very dry mucous membrane
greatly elevated heart rate
decreased skin turgor
very sunken eyes
very sunken fontanel
lethargy
cold extremities
hypotension
coma
severe dehydration amount
100mL/kg
4-2-1
for the first 10kg: 4mL/kg/hr
for the next 10kg: 2mL/kg/hr
for anything greater than 20kg: 1mL/kg/hr
4-2-1 is used for
maintenance
deficit + MIVF = IV rate
- replacement time
replace 50% in first 8 hours
replace 50% in next 16 hours
IV bolus
20ml/kg over 30-60 min
isotonic
normal sodium
135-145
normal potiussum
3.5-5
normal calcium
2.8-2.86
normal magnesium
1.6-2.4
bulging fontanelle = increased
ICP
decreased perfusuion and vascocontriction color of skin
pale/gray limbs
hands blue
increases loss by 7mL/kg/24h for each degree risk above
37.2
4 factors to predict dehydration
cap refil
absence of tears
dry mucous membranes
ill aperence
2 teaspons / in mins
15 mins
oral rehydration therapy dont give
pop
juice
increased sugar
oral rehydration therapy do give
pedilyte
when can we give potassium
after void
what is the best way to oral rehydration
oral rehydration
when to seek medical care
vomiting large volumes/sunken fontanelles
no improvmenet of symptoms after 4 hours of oral rehydration
worsening symptoms
