Peds Exam 2 - F&Ls Flashcards
holliday segar formula
need to have memorized
-first 10kg add 100 ml/kg/d
-next 10kg add 50 ml/kg/d
->20kg add 20 ml/kg/d
ex) 7kg child would get 700 ml
ex) 12kg (10x100)+(2x50) = 1100 ml
ex) 30kg (10x100)+(10X50)+(10x20) = 1700 ml
divide by 24 to get per hr
factors increasing maintenance fluid requirements
-fever over 99
-tachypnea
-increased environment temp
-burns
-V/D
-DKA
-shock
-radiant warmer, phototherapy
-post opt bowel surgery
factors decreasing maintenance fluid requirements: skin
mist tent, incubator, swamp bed
factors decreasing maintenance fluid requirements: lungs
humidified ventilator
factors decreasing maintenance fluid requirements: renal
oliguria, anuria
factors decreasing maintenance fluid requirements: misc.
hypothyroidism
factors decreasing maintenance fluid requirements
-CHF
-increased intracranial pressure
-syndrome or inappropriate antidiuretic hormone (SIADH)
types of dehydration: isotonic
-lytes = water
-serum Na 135-145
-80% of all dehydration pts
no need to correct slowly
types of dehydration: hypertonic
-water loss > lyte loss
-Na > 145
-15% of all dehydration pts
-dry doughy skin
-if lowered too quickly causes massive cerebral edema or seizure
correct Na slowly
types of dehydration: hypotonic
-lyte loss > water loss
-Na <135
-5% all dehydration pts d/t GI loss
-shift from ECF to ICF
-child appears ill
correct very slowly
what do you have to have the child do before giving K+ in IV fluid
urinate
water balance - maintenance
normal ongoing losses of fluid and electrolytes
water balance - deficit
total amount of fluids and electrolytes lost from an illness
water balance - on going losses
requirement of fluids and electrolytes to replace ongoing losses
how much do you increase fluid needs by for a fever
by 7ml/kg/d
if you have fluid excess, what precaution do you put them in
seizure