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PRAXIS TEST 2 (year 3) > Pediatric Hydration Assessment > Flashcards

Pediatric Hydration Assessment Flashcards

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1
Q

What is sensible fluid losses

A

Measurable losses of fluid

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2
Q

List examples of sensible fluid losses

A

Urine
Emesis
Diarrhea
Blood

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3
Q

Describe insensible fluid losses

A

Unmeasurable fluid losses

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4
Q

List examples of insensible fluid losses

A

Lungs
Skin
Respiratory tract
Water excreted in feces

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5
Q

What factors influence insensible fluid losses

A

Suctioning
Diaphoresis
Fever
Hyperthermia
Increased activity
Hyperventilation
Radiant warmers
Phototherapy

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6
Q

How many ml do adults lose daily under normal circumstances?

A

40 to 600ml daily

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7
Q

Why do infant and toddlers have more water loss from the skin compared to adults?

A

Bc they have a higher body surface area to weight ratio than adults

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8
Q

_______: bc of their high resp rate, have ______ __________ losses from the _______ ________

A

Infants: bc of their high resp rate, have higher insensible losses from the respiratory tract

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9
Q

What is fluid volume deficit

A

Fluid output exceeds fluid intake

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10
Q

Fluid volume deficit:
Loss of water and electrolytes due to:

A

Fever, GI suction (ex; low intermittent suction), vomiting, diarrhea, increased urine output (polyuria)

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11
Q

Signs and symptoms of fluid volume deficit

A

Dry mucous membranes
Decreased skin turgor
Urine output <1ml/kg/hr
Hypotension
Sunken eyes
Depressed fontanels
Lack of tears
Dry, cracked tongue

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12
Q

What is fluid volume excess

A

Hypovalemia;
Too much fluid volume in body

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13
Q

Fluid volume excess S&S

A

Peripheral edema
Puffy eyes
Full/bulging fontanels
“Wet” chest
Pulmonary edema
Pleural effusions
Ascites ( fluid accumulation within the abdominal cavity)
Distended neck veins
Bounding pulses
Deceased urinary output

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14
Q

Special considerations;
R/T fluids (infants)

A

-have proportionally more body water

-vulnerable to fluid volume deficit

-have high metabolic rate and large metabolic wastes to excrete daily

-relatively larger water intake than older children

-immature kidneys which are unable to concentrate urine efficiently

-greater fluid loss through the skin

-prone to fluid/electrolyte imbalance

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15
Q

How do you measure intake?

A
  1. Monitor oral intake
    - note time and amount
    -document on fluid balance record
  2. Monitor intake and output given parenterally (by iv) or any other means
  3. End of shift document intake
    -document fluid balance record
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16
Q

How to measure urine output (INfants)

A

1.NOT in diapers
-measure each void using measuring devices available on unit

  1. IN DIAPERS
    -weight dry diaper (grams)
    -place dirty diaper in garbage bag
    -place soiled diaper in bag on scale
    -find weight in grams (1g=1ml)
    -document urine or stool
17
Q

What are other outputs?

A

Emesis
Blood
Loss from nasogastric tube or other tubes

18
Q

How do you calculate fluid balance

A

Total intake - total output = _____ml

19
Q

If the patient has more fluid __ than __ the patient is in a positive balance.

If the patient has more fluid __ than __ the patient is in a negative balance.

A
  1. In/out =positive
    2.out/in= negative
20
Q

How do you calculate output in ml/kg/hr?

A

-done at the end of your shift

Total urine output
—————————
Patient weight
—————————
# hours in your shift
=ml/kg/hr

21
Q

Urine output:
What are the expected outcomes for children less than 1 year and older than 1

A

Less than one:
-minimally 2 ml/kg/hr

One year or older
-minimally 1 ml/kg/hr

22
Q

What is ad lib on demand

A

How much a newborn should be drinking:
—————>means drink when they want and however much they want

23
Q

TFI (total fluid intake)
From day of birth to day 5

A

Birth: 60 ml/kg/day
1: 80
2: 100
3: 120
4: 140
5: 160

24
Q

How to calculate ml/kg/day

A

Multiply TFI by weight of baby

25
Q

4-2-1 rule

A

4 ml/ kg for the first 10kg of pt weight
2ml/kg for the next 10kg of pt weight
1ml/kg for the remainder of the weight

Example:
Weight is 56

So:
4x10= 40
2x10= 20
1x36= 36
—
56. 96 ml/hr is maintenance iv for this child

PRAXIS TEST 2 (year 3) (3 decks)

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