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PHM704 Pediatrics/Geriatrics > Pediatrics - Fluids & Electrolytes > Flashcards

Pediatrics - Fluids & Electrolytes Flashcards

1
Q

What is the most common cause of dehydration in pediatrics?

A

viral gastroenteritis

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2
Q

What percents indicate mild dehydration in infants and older children?

A

1-5%, 1-3%

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3
Q

What percents indicate moderate dehydration in infants and older children?

A

6-9%, 4-6%

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4
Q

What percents indicate severe dehydration in infants and older children?

A

> 10% (15 or more = shock), >6% (9% or more = shock)

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5
Q

What are characteristics of mild dehydration?

A

mostly normal, buccal mucosa slightly dry, decreased urine output, drinks normally

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6
Q

What are characteristics of moderate dehydration?

A

tachycardia, little/no urine output, dry mucosa, sunken eyes/anterior fontanelle, delayed capillary refill, cool/pale, listless, thirsty

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7
Q

What are characteristics of severe dehydration?

A

rapid/weak pulse, decreased SBP, parched mucosa, very sunken eyes/anterior fontanelle, delayed capillary refill, cool/mottled, acryocyanosis, lethargic/comatose, drinks poorly/unable

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8
Q

What is the formula for dehydration estimation?

A

severity of dehydration = [(pre-illness weight (kg) - illness weight (kg))/pre-illness weight (kg)] x 100%

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9
Q

What is the formula for fluid deficit?

A

fluid deficit (L) = % dehydration x pre-illness weight (kg) / 100

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10
Q

What is used for mild-to-moderate dehydration treatment?

A

oral replacement therapy (ORT)

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11
Q

What is used for severe dehydration treatment?

A

intravenous fluid (IVF)

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12
Q

What is the ORT treatment for mild dehydration?

A

50 mL/kg over 4hrs, reassess q2hrs

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13
Q

What is the ORT treatment for moderate dehydration?

A

100 mL/kg over 4hrs, reassess qhr

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14
Q

How much ORT should be added for each loose stool/vomiting episode?

A

10 mL/kg

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15
Q

What is the IVF treatment for severe dehydration (Phase I/initial replacement)?

A

10-20 mL/kg of 0.9% NS or LR over 30-60min, repeating up to 3 times

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16
Q

What is the IVF treatment for severe dehydration (Phase II/maintenance replacement)?

A

first 8 hours = replace fluid deficit, following 16 hours = provide maintenance rate

17
Q

When is D10W used in pediatric dehydration?

A

neonates or infants with hypoglycemia

18
Q

What is the standard potassium concentration?

A

20 mEq/L

19
Q

What is the standard negative anion?

A

chloride

20
Q

What is the maximum MIVF?

A

100 mL/hr and 1.5-2x MIVF

21
Q

What is the maintenance IVF fluid requirement for non-neonates <10 kg?

A

4 mL/kg/hr

22
Q

What is the maintenance IVF fluid requirement for non-neonates 10-20 kg?

A

40 mL/hr + 2 mL/kg/hr x (weight - 10 kg)

23
Q

What is the maintenance IVF fluid requirement for non-neonates >20 kg?

A

60 mL/hr + 1 mL/kg/hr x (weight - 20 kg)

24
Q

What is the dose for ondansetron in patients >6 months of age?

A

0.15-0.3 mg/kg/dose

25
Q

What is the dose for ondansetron in patients weighing 8-15 kg?

A

2 mg once

26
Q

What is the dose for ondansetron in patients weighing 15-30 kg?

A

4 mg once

27
Q

What is the dose for ondansetron in patients weighing >30 kg?

A

8 mg once

28
Q

What are AEs of ondansetron?

A

QTc prolongation, arrhythmias

29
Q

What probiotics are not recommended though sometimes used in gastroenteritis? (2)

A

lactobacillus rhamnosus GG and saccharomyces boulardii

30
Q

When is zinc useful for gastroenteritis in pediatrics?

A

patients with nutrient deficiencies (malnutrition)

31
Q

What is the dose for elemental zinc in those <6 months? 6 or more?

A

10 mg/day for 10-14 days; 20 mg/day for 10-14 days

32
Q

Which antidiarrheal agents should be used cautiously in children with gastroenteritis? (3)

A

antimotility (loperamide), anticholinergic (hyoscyamine), and antisecretory (bismuth subsalicylate)

PHM704 Pediatrics/Geriatrics (14 decks)

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