Fluids & Acid-Base Imbalance Flashcards
What percentage of newborns is composed of water?
75%
What percentage of infants are composed of water?
65%
What percentage of children / adolescents are composed of water?
50%
What factors contribute to electrolyte imbalance in children?
- body surface area
- ↑ RR
- ↑ respiratory & metabolic demands
What is different about the daily water need of newborns?
KNOW THIS!!!!!
4-5 times GREATER daily water need per kg
What 3 factors in children can lead to insensible fluid loss, dehydration, & electrolyte imbalance?
KNOW THIS!!!!!
- ↑ body surface area
- ↑ metabolic demands
- ↓ systemic regulation
Clinical Assessment of Fluid Imbalances - Vascular Volume
KNOW THE BOLD!!!!!
KNOW THIS!!!!! ↑ ↓
- Capillary refill
- ↓ pulse
- ↓ BP (= late sign)
- Central venous pressure (CVP)
- sunken fontanelles
- I/Os
- ↓ tears
- urine specific gravity
- mucous membranes
Clinical Assessment of Fluid Imbalances - Interstitial Volume
KNOW THIS!!!!
- Skin turgor
- Presence or absence of edema
What is 1 L of fluid lost equal to in terms of weight?
KNOW THIS!!!!!
1 kg lost (weight loss)
Normal Urine Output in Children
KNOW THIS!!!!!
0.5 - 1 mL/kg/hr
Normal Urine Output for an INFANT
KNOW THIS!!!!!
2 mL/kg/hr
What are the 3 main causes of dehydration in children?
KNOW THIS!!!!!
- ↓ intake
- ↑ output (GI loss, renal loss)
- translocation (burns, edema, etc.)
What are causes of dehydration?
KNOW THE BOLD!!!!!
- Diarrhea
- Vomiting
- Gastroenteritis
- Stomatitis or pharyngitis
- Fever
- DKA
- DI
- Burns
Isoctonic
KNOW THIS!!!!
- Fluid loss cannot be compensated by fluid intake
- Na+ & water are lost in proportion to each other
- Na+ is normal
H2O = Na
Hypotonic
KNOW THIS!!!!!
- Na+ loss is greater than water loss
- Na+ is low
- Fluid shifts from ECF to ICF to attempt to correct worsening dehydration
H2O < Na+
Hypertonic
KNOW THIS!!!!!
- Water loss is greater than Na+ loss
- Na+ is HIGH
- Fluid moves from ICF to ECF & thus s/s appear late
H2O > Na+