Peds Flashcards
What type of dehydration is common in gastroenteritis?
Isonatremic
Proportional loss of Na and water
Na 130-150
Isonatremic dehydration
Na >150
Implies free water loss of increaesed insensible losses (SIADH)
Hypernatremic dehydration
Na <130
Excess loss of Na or commonly fluid replacement w/ excess free water
Hyponatremic
5 Steps to Replacement of Fluid in Dehydration
- Restore intravascular volume for hemodynamic stability: the boluses!
- Calculate 24 hr water requirements
Maintenance – given at constant rate over 24 hrs
Deficit – divided so that ½ is given over first 8 hrs, then ½ over the next 16 hrs. - Calculate 24 hr electrolyte requirements
Maintenance Na+ and K+
Deficit Na+ and K+ (especially important in hypo/hypernatremic dehydration) - Select appropriate fluids
- Replace ongoing losses
What’s the calculation for fluid deficit?
Fluid deficit (mL) = % dehydration of pre-illness wt (kg) x 1000 ml/kg Remember to subtract the bolus amt from the fluid deficit
What do you do with an infant with a probably obstruction?
- Place NG tube with suction
- NPO (nothing per oral)
- Begin IVF
- Abd x-ray
Double bubble sign
Duodenal atresia
Which is more common viral or bacterial?
Viral!
Vomiting followed by watery diarrhea
Viral gastroenteritis
Standard medical care of GERD
Appropriate amt of formula
Thickening feedings by adding rice cereal
Prone at 30 degrees while awake
Hold upright for 30 min after feeding
Maintenance fluid calculations 24 hours
First 10 kg x 100ml
Additional 11-20kg x 50ml
Remainder kg x 20ml
= 24 hr calculation
Hourly calculation maintenance fluids
First 10 kg x 4ml
Additional 11-20kg x 2ml
Remainder kg x 1ml
Where does the esophagus pierce the diaphragm
T10
