Fluid Management In Children

Question 1

what is maintenance fluid?

Answer 1

To replace insensible losses

Allows excretion of excess solute load in urine

Question 2

What is resuscitation fluid?

Answer 2

Replacement fluid for losses (blood, vomit, sweat)

Question 3

Diarrhoea, lose what?

Answer 3

K+, can lose a lot

Question 4

Major cation intra cellularly?

Answer 4

K+

Question 5

Major cation extracellular ly?

Answer 5

Na+

Question 6

What is tonicity?

Answer 6

Concentration of solutes that exerts an osmotic force across a membrane

Question 7

Does Glucose exert osmotic force?

Answer 7

Nope, usually not, no tonic force

Question 8

Normal Values of osmolality?

Answer 8

270-295mmol/kg

~280

Question 9

Role of sodium in fluids?

Answer 9

Most important ECF cation
Maintains plasma tonicity and ECF volume
USUALLY reflects water balance.

Question 10

Problems with fluids in children that come up?

Answer 10

Hyponatraemia

Encephalopathy

Question 11

ADH does what?

Answer 11

Water retention at kidneys

Moves from ECF to ICF

Question 12

Purpose of stress response?

Answer 12

Glucagon gets mobilized

Question 13

What is natriuresis?

Answer 13

Losing Na+ in urine

Question 14

What causes natriuresis? Mechanism?

Answer 14

ANPeptide
Stretch at atrium
Due to volume loading

Question 15

Why children at risk for hyponatraemia?

Answer 15

Large brain:, increase ICP

Question 16

When do seizures occur in adults/children?

Answer 16

Children :Na:

Question 17

THings to consider when prescribing fluid?

Answer 17

Volume/rate
Na
K
Energy

Question 18

How much energy in 5% dextrose. 1000ml?

Answer 18

200cal

Question 19

Paediatric IV maintenance Study (PIMS)

Answer 19

Plasma-lyte vs. 0.45% NaCL in 5%D

Less ppl became hyponatraemic on Plasmalyte

Question 20

Stress response causes?

Answer 20

Water retention

Question 21

Remember what when give fluids to kids?

Answer 21

Kids eat and drink early. Need to adjust

Question 22

give What fluids to really sick kids?

Answer 22

Relative fluid restriction
2/1/1.  Or 2/3 maintenance
Plasma review
daily electrolytes
Reduce once drinking

Question 23

High risk groups that retain more fluid? How to maintain?

Answer 23

Meningitis
Neonate S
Craniotomy-facial/neurosurg/Major surg
Anyone who needs full maintenance

Daily electrolytes

Question 24

Role of dextrose solution?

Answer 24

1. Prevent hypoglycaemia, prev. Ketosis

2. To give free water into a peripheral vein: prev. Haemolysis

Question 25

When give TPN?

Answer 25

When not eating or drinking for more than a few days. Liver glycogen stores depleted.