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Child Health Nursing > Lecture 7+ Fluid and electrolyte imbalances in children > Flashcards

Lecture 7+ Fluid and electrolyte imbalances in children Flashcards

1
Q

What are the two places extracellular fluids are found?

A

Interstitial (surrounding the cell) and intravascular (contained within the blood vessels).

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2
Q

Name the 3 major determinants of osmotic pressure.

A

Sodium Glucose Protein

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3
Q

What percentage of water are infants?

A

75% (adults: 60%).

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4
Q

What are the parameters for a normal serum Sodium level?

A

Between 134 and 146 mEq/L.

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5
Q

Serum osmolality is usually _ the amount of a serum Sodium level.

A

roughly double

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6
Q
  1. Name the seven conditions that cause increased fluid requirements in children?
A

(1) Fever. (2) Vomiting/diarrhea. (3) High output renal failure. (4) Diabetes insipidus. (5) Burns. (6) Shock. (7) Tachypnea.

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7
Q
  1. Name the six conditions that cause decreased fluid requirement.
A

(1) Congestive heart failure. (2) Syndrome of inappropriate antidiuretic hormone (SIADH). (3) Mechanical ventilation. (4) Postoperatively. (5) Oliguric renal failure. (6) Increased intracranial pressure.

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8
Q
  1. What is the minimal urine output for a toddler/child?
A

a) 1cc/kg/hr.

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9
Q
  1. What are the 2 types of IVF’s that should be used for moderate to severe dehydration for fluid resuscitation of a pediatric patient?
A

Normal saline and Lactated Ringers.

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10
Q

A pt. comes to the ER with moderate to severe dehydration. The appropriate fluids to hang would be

A

D5W1/2NS [KCl cannot be added until after the 2nd void.]

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11
Q
  1. Why is hypernatremic dehydration considered the most dangerous to treat?
A

Fluid losses must be replaced slowly (48 hours instead of 24 hours) and carefully (full strength NS, not half or quarter strength); rapid rehydration can result in increased intracranial pressure.

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12
Q
  1. Why is it hard for infants to concentrate and dilute urine?
A

The infant’s kidneys are functionally immature at birth and are therefore inefficient in excreting waste products of metabolism.

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13
Q
  1. What are the three types of dehydration?
A

Isotonic (loss of water and salt); hypotonic (loss of salt in excess of water); and hypertonic (loss of water in excess of salt).

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14
Q
  1. Patients whose third space have increased Sodium levels in their _
A

Interstitial space.

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15
Q
  1. Name five clinical signs of severe dehydration.
A

(1) Anterior fontanel markedly depressed. (2) Eyes markedly sunken/dark. (3) Mucous membranes parched. (4) Skin color acrocyanotic/mottled with very delayed (>4 seconds) capillary refill. (5) Rapid, weak pulse and rapid, deep respirations.

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16
Q
  1. A baby appears in the emergency room. Their fontanel is sunken with mottled skin. These clinical signs show which type of dehydration:
A

Severe.

17
Q
  1. A child presents to the ER restless and slightly lethargic. They are tachycardic with normal/deep respirations. Their admitting diagnosis would be which type of dehydration
A

Moderate

18
Q

A patient comes to the ER with a normal BP and 5% weight loss. This would be considered _ dehydration.

A

Mild.

19
Q
  1. In isotonic dehydration, hematocrit, urine specific gravity, and BUN are abnormal. Which result remains normal?
A

Serum sodium.

20
Q
  1. Mild to moderate dehydration may be treated with _
A

Oral rehydration.

21
Q
  1. Oral Rehydration is usually accomplished over _
A

4 hours.

22
Q
  1. Why does Hypotonic/Hyponatremic dehydration occur?
A

This type of dehydration occurs when the serum sodium is below normal (less than 135 mEq/L) because the electrolyte deficit exceeds the water deficit. The most common cause of hypotonic/hyponatremic dehydration is the administration of fluid that is too low in sodium to a child who is already dehydrated.

23
Q
  1. Severe hyponatremia
A

Seizures

24
Q
  1. The most common pathogen for diarrhea is _
A

Rotavirus.

25
Q
  1. Acute diarrhea causes _
A

Metabolic acidosis.

Child Health Nursing (16 decks)

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