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PHM 704- Pediatrics > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Outpatient management of gastroenteritis: ondansetron MoA

A

Selective 5-HT3 receptor antagonist

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2
Q

Recommendation for ondansetron

A

Administer as a single dose, PO or IV, to assist patients in tolerating ORT

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3
Q

Ondansetron ADEs

A

QTc prolongation, arrhythmias

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4
Q

Outpatient management of gastroenteritis: probiotics MoA

A

assists in re-establishing normal intestinal flora, suppresses growth of pathogenic microorganisms through lactic acid, resulting in an acidic environment

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5
Q

Probiotic recommendation

A

Low quality of evidence to support universal recommendation

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6
Q

Outpatient management of gastroenteritis: zinc

A

Not really used in developed countries

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7
Q

Dosage forms of zinc are expressed in the _____ form, which is ______% elemental zinc.

A

Expressed in the salt form, which is 23% elemental zinc

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8
Q

Elemental zinc dose: <6 months

A

10mg/day x10-14 days

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9
Q

Elemental zinc dose: ≥6 months and children

A

20mg/day x10-14 days

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10
Q

Avoid what in gastroenteritis treatment in children?

A

Loperamide, antisecretory agents like bismuth subsalicylate and metoclopramide

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11
Q

Dehydration and percent changes in weight: mild dehydration in infants

A

1-5%

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12
Q

Dehydration and percent changes in weight: mild dehydration in older children

A

1-3%

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13
Q

Dehydration and percent changes in weight: moderate dehydration in infants

A

6-9%

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14
Q

Dehydration and percent changes in weight: moderate dehydration in older children

A

4-6%

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15
Q

Dehydration and percent changes in weight: severe dehydration in infants

A

> 10%, ≥15% is shock

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16
Q

Dehydration and percent changes in weight: severe dehydration in older children

A

> 6%, ≥9% shock

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17
Q

Signs of mild dehydration in infants and older children (generally)

A

Overall, pretty much normal, but may have an increased pulse, decreased urine output, and slightly dry buccal mucosa

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18
Q

Signs of moderate dehydration in infants and older children (generally)

A

Tachycardia, may have low BP, everything else is dry, sunken, cool, thirsty, may have slightly altered mental status

19
Q

Signs of severe dehydration in infants and older children (generally)

A

Basically, take the moderate dehydration signs and symptoms and make them more sunken, not drinking at all, rapid and weak pulse, almost comatose

20
Q

Formula for severity of dehydration

A

[pre-illness weight (kg)- illness weight (kg)]/pre-illness weight x 100%

21
Q

Fluid deficit formula

A

% dehydration x pre-illness weight / 100

22
Q

Components of an IVF bag

A

Sodium, dextrose, potassium

23
Q

Sodium concentration in IVF bags (typically)

A

NS!

24
Q

Dextrose concentration in IVF bags (typically)

A

D5W!

25
Q

Potassium concentration in IVF bags (typically)

A

20 mEq/L

26
Q

Additional electrolytes in IVF bags

A

Mg, phosphate, calcium based on individual needs

27
Q

Standard negative anion added to IVF bags

A

Chloride

28
Q

Formula for MIVF rate calculation: weight <10kg

A

100ml/kg

29
Q

Formula for MIVF rate calculation: weight 10-20kg

A

1000mL+50ml/kg (each kg >10kg)

30
Q

Formula for MIVF rate calculation: >20kg

A

1500ml+20ml/kg(each kg >20kg)

31
Q

Goal of therapy for dehydration treatment

A

Restore fluid and electrolyte balance in combination with early introduction of appropriate food and PO liquids as directed

32
Q

What will determine the treatment strategy selected?

A

Degree of dehydration

33
Q

Treatment for mild-moderate dehydration

A

ORT

34
Q

ORT dosing: mild dehydration

A

50ml/kg over a 4-hour period, reassess q2h

35
Q

ORT dosing: moderate dehydration

A

100mg/kg over a 4-hour period, reassess q2h

36
Q

ORT dosing: add an additional ________ per each _________

A

Add an additional 10ml/kg per each loose stool/vomiting episode for both mild and moderate dehydration

37
Q

Severe dehydration treatment (generally)

A

IVF

38
Q

Phase I of severe dehydration treatment

A

Give IV bolus fluids

39
Q

Phase I IVF bolus dose

A

10-20ml/kg/dose of NS or LR over 30-60 minutes; repeat up to 3 times PRN

40
Q

Phase II of severe dehydration treatment

A

maintenance replacement

41
Q

Phase II treatment: first 8 hours

A

calculate and replace fluid deficit

42
Q

Phase II treatment: next 16 hours

A

calculate and provide maintenance rate

43
Q

Monitoring parameters for dehydration treatment

A

Normalization of BP
Adequate urine output for age/weight
Improvement in clinical signs and symptoms of dehydration
Normalization of serum electrolytes/laboratory parameters

PHM 704- Pediatrics (17 decks)

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