Test 2: Fluid & Electrolyte Balance Flashcards
What causes an infant to fluid imbalance?
1) greater surface area in relation to body mass
2) greater fluid loss in insensible loss (skin and GI tract)
3) Stomach capacity is smaller
4) GI motility is faster in infants
5) Higher metabolic rate
6) Digestive enzymes usually not present until 4-6 months
What is the formula for calculating fluid needs for a pediatric patient?
Output: 1-2 mL/kg hour
Input:
- Up to 10 kg: 100 mL/kg
- 10-20 kg: 1000 mL + 50 mL/kg for over 10kg
- over 20 kg: 1500 mL + 20 mL/kg for over 20 kg
Calculate the percent of dehydration…
SUBTRACT child’s weight loss from original weight
DIVIDE by child’s original weight
MULTIPLY by 100 to get a percentage
What are signs of dehydration?
- decreased urine output
- hard feces
- diaphoresis
- tachypnea
- dry mucus membranes
- poor skin turgor
- absence of tears
What are signs of water excess?
- edema
- elevated venous pressure
- hepatomegaly
- slow/bounding puls
- weight gain
- lethargy
- increased spinal fluid pressure
- CNS: seizures/coma
What are signs of sodium excess?
- intense thirst
- dry, sticky membranes
- flushed skin
- increased temp
- hoarseness
- oliguria
- N/V
- CNS symptoms
What are signs of water depletion?
- thirst
- variable temp
- dry skin & mucous membranes
- poor skin tugor
- poor perfusion
- weight loss
- fatigue
- diminished urinary output
- irritability & lethargy
- tachycardia
- tachypnea
- disorientation
What are signs of potassium excess?
- muscle weakness
- flaccid paralysis
- twitching
- hyperreflexia
- bradycardia
- ekg changes
- v-fib/cardiac arrest
- oliguria
- apnea
Define isotonic dehydration:
Equal loss of electrolytes and water
most common dehydration in peds
Define hypotonic dehydration:
more water than electrolytes
Define hypertonic dehydration:
more electrolytes than water
(large loss of water or large intake of electrolytes)
Most dangerous!
Why strict I & O’s on children?
Urine output is the single best indicator fluid balance
pH
metabolic acidosis
- diarrhea depletes alkaline intestinal secretions
pH > 7.45
Vomiting
metabolic alkalosis
- vomiting depletes stomach acid
What type of pathogen?
E. coli, salmonella, shigella, yersinia enterocolitica, capylobacter jejuni, vibrio cholera, C. diff
Bacteria
