Pediatrics - Fluids & Electrolytes Flashcards
What is the most common cause of dehydration in pediatrics?
viral gastroenteritis
What percents indicate mild dehydration in infants and older children?
1-5%, 1-3%
What percents indicate moderate dehydration in infants and older children?
6-9%, 4-6%
What percents indicate severe dehydration in infants and older children?
> 10% (15 or more = shock), >6% (9% or more = shock)
What are characteristics of mild dehydration?
mostly normal, buccal mucosa slightly dry, decreased urine output, drinks normally
What are characteristics of moderate dehydration?
tachycardia, little/no urine output, dry mucosa, sunken eyes/anterior fontanelle, delayed capillary refill, cool/pale, listless, thirsty
What are characteristics of severe dehydration?
rapid/weak pulse, decreased SBP, parched mucosa, very sunken eyes/anterior fontanelle, delayed capillary refill, cool/mottled, acryocyanosis, lethargic/comatose, drinks poorly/unable
What is the formula for dehydration estimation?
severity of dehydration = [(pre-illness weight (kg) - illness weight (kg))/pre-illness weight (kg)] x 100%
What is the formula for fluid deficit?
fluid deficit (L) = % dehydration x pre-illness weight (kg) / 100
What is used for mild-to-moderate dehydration treatment?
oral replacement therapy (ORT)
What is used for severe dehydration treatment?
intravenous fluid (IVF)
What is the ORT treatment for mild dehydration?
50 mL/kg over 4hrs, reassess q2hrs
What is the ORT treatment for moderate dehydration?
100 mL/kg over 4hrs, reassess qhr
How much ORT should be added for each loose stool/vomiting episode?
10 mL/kg
What is the IVF treatment for severe dehydration (Phase I/initial replacement)?
10-20 mL/kg of 0.9% NS or LR over 30-60min, repeating up to 3 times
What is the IVF treatment for severe dehydration (Phase II/maintenance replacement)?
first 8 hours = replace fluid deficit, following 16 hours = provide maintenance rate
When is D10W used in pediatric dehydration?
neonates or infants with hypoglycemia
What is the standard potassium concentration?
20 mEq/L
What is the standard negative anion?
chloride
What is the maximum MIVF?
100 mL/hr and 1.5-2x MIVF
What is the maintenance IVF fluid requirement for non-neonates <10 kg?
4 mL/kg/hr
What is the maintenance IVF fluid requirement for non-neonates 10-20 kg?
40 mL/hr + 2 mL/kg/hr x (weight - 10 kg)
What is the maintenance IVF fluid requirement for non-neonates >20 kg?
60 mL/hr + 1 mL/kg/hr x (weight - 20 kg)
What is the dose for ondansetron in patients >6 months of age?
0.15-0.3 mg/kg/dose
