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Phase 3a topics > Fluids and developmental milestones > Flashcards

Fluids and developmental milestones Flashcards

1
Q

maintenance fluids neonates

A

10% dextrose
Day 1 – 60 mls/kg/day
Day 2 – 90 mls/kg/day
Day 3 – 120 mls/kg/day
Day 4 – 150 mls/kg/day

From day 2
Na 3 mmol/kg/day
K 2 mmol/kg/day
Ca 1 mmol/kg/day (rarely)

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2
Q

estimating weight ?

A

(Age + 4) x2 = weight in kg

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3
Q

maintenance fluids children

A

0.9% sodium chloride + 5% glucose (+/- KCl)
Weight Daily (ml/24h)

First 10 kg 100 ml/kg
Next 10 kg 50 ml/kg
Every other kg 20 ml/kg

Rate (ml/h): Total (ml) / 24

Sodium: 2-4mmol/kg/day
Potassium: 1-2mmol/kg/day

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4
Q

signs of shock

% defecit?

A

Reduced consciousness
Cold, mottled peripheries
Low blood pressure (decompensated shock)
Prolonged capillary refill time
Weak peripheral pulses
Anuria
tachycardia
tachypnoea

10%

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5
Q

signs of dehydration

%defecit?

A

Irritable, lethargic, altered response*
appears unwell*
sunken eyes*
reduced skin turgor*
tachycardia*
tachypnoea*

Thirst
Dry lips
Decreased urine output
Normal blood pressure
Normal CRT
Skin colour normal

5%

*indicates at risk of progression to shock

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6
Q

calculating fluids to correct deficit

A

Deficit(%) x 10 x Wt(kg)

+ maintenance

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7
Q

hydration if can tolerate oral

A

give 50 ml/kg low osmolarity oral rehydration solution (ORS) solution over 4 hours, plus ORS solution for maintenance, often and in small amounts

continue breastfeeding

consider supplementing with usual fluids (including milk feeds or water, but not fruit juices or carbonated drinks)

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8
Q

what bolus would you give in shock

A

10 mls/kg of 0.9% sodium chloride bolus

If they were shocked and in DKA then you would not minus the initial bolus when calculating full regime

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9
Q

signs of hypernautraemic dehydration?

A

jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma

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10
Q

Gross motor referrals

A

Can’t sit without support at 12 months

Can’t walk unsupported at 18 months

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11
Q

no head lag on being pulled to sit

A

3 months

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12
Q

rolling over

A

5 months

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13
Q

sits without support

A

7-8 months

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14
Q

crawl (+pull to stand)

A

9 months

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15
Q

walking (cruising, with hand held)

A

12 months

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16
Q

run

A

2 years

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17
Q

walk up stairs with no rail

A

3 years

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18
Q

hops on one leg

A

4 years

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19
Q

reaches for object, hold briefly

A

3 months

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20
Q

palmar grasp, transfer object from one hand to another

A

6 months

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21
Q

early pincer grip, points with finger

A

9 months

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22
Q

good pincer grip

A

12 months

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23
Q

Ages for stacking bricks

A

15 months - tower of 2
18 months - tower of 3
2 years - tower of 6
3 years - tower of 9

24
Q

ages for drawing

A

18 months - circular scribble
2 years - straight line
3 years - circle
4 years - cross and RvL
4.5 years - square
5 years - triangle

25
Q

Fine motor referral

A

Hand preference before 12 months is indicative of cerebral palsy

26
Q

Quietens to parents voice
Turns towards sound
Squeals

A

3 months

27
Q

Double syllables ‘adah’, ‘erleh’

A

6 months

28
Q

Says ‘mama’ and ‘dada’
Understands ‘no’

A

9 months

29
Q

Knows and responds to own name

A

12 months

30
Q

Knows about 2-6 words

Understands simple commands - ‘give it to mummy’

A

12-15 months

31
Q

Combine two words
Points to parts of the body

A

2 years

32
Q

Vocabulary of 200 words

A

2.5 years

33
Q

Talks in short sentences (e.g. 3-5 words)
Asks ‘what’ and ‘who’ questions
Identifies colours
Counts to 10 (little appreciation of numbers though)

A

3 years

34
Q

Language referral

A

If not 2-6 words by 18 months, refer

35
Q

Smiles (Refer at 10 weeks)
Eye tracing

A

6 weeks

36
Q

Laughs
Enjoys friendly handling

A

3 months

37
Q

Not shy

A

6 months

38
Q

Shy
Takes everything to mouth

A

9 months

39
Q

points with finger/waving bye bye

A

10 months

40
Q

Plays contentedly alone

A

18 months

41
Q

Plays near others, not with them

A

2 years

42
Q

Plays with other children

A

4 years

43
Q

Drinks from cup + uses spoon, develops over 3 month period

A

12 -15 months

44
Q

Competent with spoon, doesn’t spill with cup

A

2 years

45
Q

Helps getting dressed/undressed

A

12-15 months

46
Q

Can dress and undress independently except for laces and buttons

A

4 years

47
Q

corrected age

A

The corrected age of a premature baby is the age minus the number of weeks he/she was born early from 40 weeks

48
Q

type 1 hypersensitivity

A

IgE mediated

anaphylaxis
allergy
atopy

49
Q

type 2 hypersensitivity

A

Cytotoxic reaction mediated by IgG or IgM antibodies

eg rheumatic fever, ITP

50
Q

type 3 hypersensitivity

A

Immune complex-mediated reaction

post-streptococcal glomerulonephritis, systemic lupus erythematosus, farmers’ lung (hypersensitivity pneumonitis), and rheumatoid arthritis.

51
Q

type 4 hypersensitivity

A

T cells that provoke an inflammatory reaction against exogenous or endogenous antigens

DELAYED

eg contact dermatitis, drug hypersensitivity

52
Q

Over how long do you give fluid resusciation?

A

15 mins if shocked
30 mins if dehydrated

53
Q

when do you minus bolus from defecit?

A

when dehydrated, not shocked

54
Q

Over how long do you correct defecit?

A

over 24 hours

Over 48 hours If DKA or electrolyte stuff

55
Q

When do you give bolus

A
  • DKA, trauma, shocked,
56
Q

Calculating drop rate

A

( mls / minutes ) x drop factor (on packet)

Eg (210mls/1440 mins) x 20 = 2.9 = 3 drops per minute

Phase 3a topics (39 decks)

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