Pediatric: Fluid/Electrolyte Balance and Gastroenteritis

Question 1

What are some special considerations for pediatrics ?

Answer 1

• infants younger then 6 weeks do not produce tears
• infants have limited ability to dilute and concentrate urine

Question 2

What does a sunken fontanel mean ?

Answer 2

can be a sign of dehydration

Question 3

What does a bulging fontanel mean ?

Answer 3

can indicate fluid overload
- don’t assess when baby is crying because crying can cause the fontanel to bulge or pulsate (which is normal in this case)

Question 4

What are some causes of dehydration ?

Answer 4

• insensible fluid loss
• increased renal excretion
• GI tract dysfunction (V and D)
• ketoacidosis
• burns

Question 5

What is Isotonic dehydration ?

Answer 5

water and sodium lost together
- primary form of dehydration
- Causes: V, D, sweating, burns, intrinsic kidney disease, hyperglycemia and hypoaldosteronism
- reduces plasma volume which affects skin, muscles and kidneys

Question 6

What is Hypotonic dehydration ?

Answer 6

electrolyte deficit exceeds water deficit
- likely caused by diuretics which causes sodium to be lost more than water
- water moves from ECF to the ICF to establish osmotic equilibrium
- this can cause shock

Question 7

What is Hypertonic dehydration ?

Answer 7

water loss exceeds electrolyte deficit
- excess pure water loss happens through skin, lungs, and kidneys
- S&S: fever, increased respirations and diabetes insipidus
- greater chance of water loss seizures happen

Question 8

In Hypertonic dehydration, what will always be elevated ?

Answer 8

serum sodium and osmolality

Question 9

What are some S&S of mild to moderate dehydration ?

Answer 9

• dry skin and mucous membranes
• poor skin turgor
• sunken anterior fontanel
• pale in color
• increased pulse
• oliguria (kidneys try to retain body fluid)
• VS may still be normal
• decreased tears
• irritability

Question 10

What are some S&S of severe dehydration ?

Answer 10

• increased pulse
• irritable to lethargic
• dry mucous membranes
• sunken eyes
• very delayed cap refill
• oliguria to anuria
• 10% weight loss infants, 6% older children

Question 11

What are some S&S of gastroenteritis ?

Answer 11

commonly caused by a virus
- nausea
- vomiting
- abdominal cramping
- diarrhea

Question 12

When you have gastroenteritis, why do you avoid fluids with high carbs ?

Answer 12

sugar exacerbates diarrhea

Question 13

Why are anti-diarrheals discouraged with gastroenteritis ?

Answer 13

you need to poop to get rid of the toxin
- only going to prolong