Peds differences in fluid, electrolytes, + acid base Flashcards
all cells produce….
acidic waste products
___ is excreted by lungs
carbonic acid
____ is excreted by kidneys
metabolic
bicarb buffer is managed by….
kidneys
pediatric differences
larger proportional wt of brain + skin
kidneys are immature under the age of…
2 y.o.
-unable to effectively conserve or excrete water
Peds have greater fluid needs due to…
high resp + metab rate
Mild Dehydration
<5% wt loss
- LOC alert, restless, thirsty
- norm BP
- reg/strong pulse
- MOIST mucus membrane
- norm UO
- norm fontanelle
- extremities are warm, rapid cap refill
- norm eyes
Moderate Dehydration
in older children
6-9% wt loss
- *LOC alert, thirsty, restless in older kids**
- *postural hypotension**
- rapid pulse
- dry mucous membranes
- decr UO
- sunken fontanelles
- delayed cap refill
- decr tears
- slightly sunken eyes
Moderate Dehydration
in infants + younger children
6-9% wt loss
- *LOC irritable, lethargic in infants/young kids**
- rapid pulse
- dry mucous membranes
- decr UO
- sunken fontanelles
- delayed cap refill
- decr tears
- slightly sunken eyes
Severe Dehydration
> 10% wt loss
- rapid weak to nonpalpable pulse
- parched mucous membrns
- very decr oe absent UO
- sunken fontanelles
- cool, discolores extremeties
- cap refill >4sec
- deeply sunken eyes
- absent tears
Severe Dehydration
level of consciousness in infants + younger children VS older children
infants + younger children: lethargic to comatose
older children: conscious + apprehensive
oral rehydration
start slowo
50-100mL/kg replaces over 4 hours for mild-mod dehydration
intravenous rehydration
for moderate to severe rehydration
how fast to give IV rehydration
24 hr fluid requirement in first 6-8hr
can be fastest during 1-3 hr to rapidly expand vascular space
