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PEDIATRICS > FLUIDS AND ELECTROLYTE PHYSIOLOGY > Flashcards

FLUIDS AND ELECTROLYTE PHYSIOLOGY Flashcards

1
Q

What are the percentages of total body water (TBW) for a newborn, 1-3 years old, and adult?

A

“Newborn: 75-80%
1-3: 65%
Adult: 55-60%

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2
Q

What is the main cation and anion in the plasma?

A

“Main cation: Sodium
main Anion: Chloride

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3
Q

What is the main cation and anion in intracellular fluid (ICF)?

A

“Main cation: Potassium
Main Anion: Phosphorus

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4
Q

What is the percentage of extracellular fluid (ECF) for a newborn, 1-3 years old, and adult?

A

“Newborn: 45%
1-3: 25%
adult: 25%

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5
Q

What is the percentage of intracellular fluid (ICF) for a newborn, 1-3 years old, and adult?

A

“Newborn: 35%
1-3: 40%
adult: 40%

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6
Q

What happens to total body water (TBW) as a person ages?

A

“Total body water decreases with age

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7
Q

What is tonicity?

A

“Tonicity is a measure of the effective pressure gradient defined by the water potential of two solutions separated by a semi-permeable membrane.”

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8
Q

Define hypotonic solution and its effect on red blood cells.

A

“In a hypotonic solution RBC’s swell-lower concentration of olutes OUTSIDE the cell + BURSTINGG (LYSIS)

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9
Q

Define isotonic solution and its effect on red blood cells.

A

“In an isotonic solution, concentration of solutes EQUAL inside & outside

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10
Q

Define hypertonic solution and its effect on red blood cells.

A

“In a hypertonic solution, solute concentration is HIGHER OUTSIDE the cell= SHRINK(CRENATION)

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11
Q

What is the source of water loss in the body?

A

“Urine (60%)
Insensible loss (30%) skin & lungs
Stool (5%)

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12
Q

What are the goals of maintenance fluids?

A

● Prevent dehydration
● Prevent electrolyte disorders
● Prevent ketoacidosis
● Prevent protein degradation

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13
Q

How do you calculate maintenance fluid requirement for the first 10 kg of body weight in pediatrics?

A

multiply by 100 mL/kg”

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14
Q

How do you calculate maintenance fluid requirement for the second 10 kg of body weight in pediatrics?

A

” multiply by 50 mL/kg”

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15
Q

How do you calculate maintenance fluid requirement for the third 10 kg or remaining weight in pediatrics?

A

“multiply by 20 mL/kg”

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16
Q

What is the Holliday-Segar Method for maintenance fluid requirement for a weight of 3-10 kg?

A

“100 mL/kg”

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17
Q

What is the Holliday-Segar Method for maintenance fluid requirement for a weight of 11-20 kg?

A

“1000 mL + 50 mL/kg (for excess over 10 kg)”

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18
Q

What is the Holliday-Segar Method for maintenance fluid requirement for a weight greater than 20 kg?

A

“1500 mL + 20 mL/kg (for excess over 20 kg)”

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19
Q

How do you calculate daily maintenance fluid volume using the body weight method for a child weighing 0-10 kg?

A

“100 mL/kg”

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20
Q

How do you calculate daily maintenance fluid volume using the body weight method for a child weighing 11-20 kg?

A

“1000 mL + 50 mL/kg (for each kg >10 kg)”

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21
Q

How do you calculate daily maintenance fluid volume using the body weight method for a child weighing over 20 kg?

A

“1500 mL + 20 mL/kg (for each kg >20 kg)”

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22
Q

What is the main electrolyte in the extracellular fluid?

A

“Sodium (Na)”

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23
Q

What is the main electrolyte in the intracellular fluid?

A

“Potassium (K)”

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24
Q

Where is the majority of potassium found in the body?

A

“Potassium is mainly found in muscles and in small amounts in the plasma.”

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25
Q

What is the dietary potassium requirement?

A

“1-2 mEq/kg”

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26
Q

How do you calculate the sodium requirement for a 10 kg patient?

A

“Na requirement = 10 kg x 3 = 30 mEq/100 mL H2O”

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27
Q

How do you calculate the potassium requirement for a 10 kg patient?

A

“K requirement = 10 kg x 2 = 20 mEq/100 mL H2O”

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28
Q

What is the goal of deficit therapy?

A

“Restore intravascular volume and replace fluid losses from pathologic causes.”

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29
Q

How is oral rehydration therapy administered?

A

“Oral rehydration therapy is administered orally or via nasogastric tube (NGT) for patients who can tolerate it.”

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30
Q

When is parenteral (intravenous) fluid therapy used?

A

“Parenteral fluid therapy is used for patients who cannot drink or are vomiting

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31
Q

What are the fluid replacement therapy amounts for mild dehydration in a patient weighing <12 kg?

A

“50 mL/kg/8 hours.”

32
Q

What are the fluid replacement therapy amounts for moderate dehydration in a patient weighing <12 kg?

A

“100 mL/kg/8 hours.”

33
Q

What are the fluid replacement therapy amounts for severe dehydration in a patient weighing <12 kg?

A

“150 mL/kg/8 hours.”

34
Q

What are the fluid replacement therapy amounts for mild dehydration in a patient weighing >12 kg?

A

“30 mL/kg/8 hours.”

35
Q

What are the fluid replacement therapy amounts for moderate dehydration in a patient weighing >12 kg?

A

“60 mL/kg/8 hours.”

36
Q

What are the fluid replacement therapy amounts for severe dehydration in a patient weighing >12 kg?

A

“90 mL/kg/8 hours.”

37
Q

How should fluids be administered in moderate dehydration?

A

Give 1/4 in 1 hour
Give 3/4 in the next 7 hours

38
Q

How should fluids be administered in severe dehydration?

A

Give 1/3 in 1 hour
Give 2/3 in the next 7 hours

39
Q

What fluids are used for moderate dehydration?

A

Plain LRS,
PNSS D5 LRS

40
Q

What fluids are used for severe dehydration?

A

Plain LRS,
PNSS D5 LRS

41
Q

What are the signs of severe dehydration?

A

Mental status: Lethargy/
unconsciousness
- Sunken eyes
- Unable to drink or drink poorly
- Skin turgor: skin pinch goes back
very slowly (≥2 seconds)

42
Q

What are the signs of some dehydration?

A

Restlessness, irritability
- Sunken eyes
- Drinks eagerly, thirsty

43
Q

What defines no dehydration?

A

“Not enough signs to classify as some or severe dehydration.”

44
Q

What is the first step in managing dehydration?

A

“Assess the patient according to the level of dehydration—mild, moderate & severe

45
Q

What is the formula for computing fluid replacement therapy for a patient under 12 kg with mild dehydration?

A

“Wt (kg) x 50 mL/kg/8 hours.”

46
Q

What is the formula for computing fluid replacement therapy for a patient over 12 kg with mild dehydration?

A

“Wt (kg) x 30 mL/kg/8 hours.”

47
Q

How should a patient be reassessed after 8 hours of fluid replacement therapy?

A

“If dehydration has resolved

48
Q

What are the sources of water loss in the gastrointestinal system?

A

Diarrhea, vomiting, nasogastric
suctioning, ostomies

49
Q

What are the sources of water loss in the renal system?

A

Diuretics, tubular-concentrating
disorders, adrenal insufficiency, diabetes
insipidus

50
Q

What are the sources of water loss in the skin?

A

Burns, sweat losses in endurance
exercise, fever

51
Q

What are the sources of water loss in third spacing?

A

Intestinal obstruction, bleeding (trauma
patients, massive bleeding), sepsis,
anaphylaxis

52
Q

What are the sources of water loss from inadequate fluid intake?

A

Physical impairment, altered mental
status, dysphagia

53
Q

What factors increase water needs from the skin?

A

radiant warmer
Phototherapy
Fever
Sweat
Burns

54
Q

What factors decrease water needs from the skin?

A

“Incubator (for premature infants).”

55
Q

What factors increase water needs from the lungs?

A

“Tachypnea & Tracheostomy

56
Q

What factors decrease water needs from the lungs?

A

“Humidified ventilator.”

57
Q

What factors increase water needs from the GIT?

A

“Diarrhea
Emesis
Nasogastric
suction

58
Q

What factors increase water needs from the renal system?

A

“Polyuria.”

59
Q

What factors decrease water needs from the renal system?

A

“Oliguria/anuria.”

60
Q

What factors increase water needs from miscellaneous sources?

A

“Surgical drain

61
Q

What is parenteral fluid therapy?

A

“Parenteral fluid therapy involves intravenous administration of crystalloids colloids, or blood products

62
Q

What are crystalloids?

A

“Crystalloids are aqueous solutions with varying concentrations of electrolytes and are most commonly used fluids in a hospital setting.”

63
Q

What is the main purpose of crystalloids?

A

“Crystalloids increase intravascular volume.”

64
Q

What are colloids?

A

“Colloids are high molecular weight substances that remain in the intravascular compartment longer than crystalloids

65
Q

What is the disadvantage of using colloids for extended periods?

A

“Colloids generate oncotic pressure and decrease blood coagulability.”

66
Q

What is the cost difference between crystalloids and colloids?

A

“Colloids are more expensive than crystalloids.”

67
Q

What is the use of albumin in fluid therapy?

A

“Albumin is used in cases of nephrotic syndrome and to remove excess fluid in patients with edema or anasarca.”

68
Q

When are colloids typically used?

A

“Colloids are the fluid of choice when there is a need for rapid fluid replacement

69
Q

What are the components of intravenous fluids?

A

“Intravenous fluids may contain sodium (Na)

70
Q

What are standard oral rehydration solutions (ORS) used for?

A

“ORS is used in patients who can drink water and are not vomiting but still need fluid replacement.”

71
Q

What is the concern with standard ORS solutions?

A

“Standard ORS contains high levels of glucose

72
Q

What is the purpose of reduced osmolarity ORS?

A

“Reduced osmolarity ORS is developed to avoid inducing dehydration while still providing effective fluid replacement.”

73
Q

What are some examples of ORS solutions?

A

“Examples include Glucolyte plus

74
Q

Which ORS solution is commonly used for patients with diarrhea?

A

“Glucolyte plus

75
Q

What is a home fluid option that has osmolarity similar to ORS?

A

“Coconut water has osmolarity similar to reformulated ORS.”

PEDIATRICS (19 decks)

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