Unit 19 Flashcards
What conditions increase the need for fluids?
Fever
GI problems (vomiting, diarrhea)
Diabetic (DKA)
Burns
Shock
Phototherapy
What conditions decrease the need for fluids?
Heart failure
Renal diseases
Ventilation
Post-op
Inappropriate antidiuretic hormone
Edema
Increased intracranial pressure
What is isotonic dehydration?
Reduced overall blood volume
Same amount of H2O and Na+ are lost
S/S: low bp, high heart rate turns into weak/thready, cold, clammy, pale, tachypnea, irritable, decreased urine output
What is hypotonic dehydration?
“Inflates” the cells, moving ECF into ICF
More Na+ than H2O is lost
Caused by: GI obstruction, burns, heat stroke, cystic fibrosis, Addison’s disease
What is hypertonic dehydration?
Depleting and dehydrating the cells.
More H2O than Na+ is lost
S/S: seizures, neuro changes, cerebral changes
What are s/s of mild dehydration?
Normal vitals
Decreased urine
Increased thirst
Jugular vein visible
3-5% weight loss
What are s/s of moderate dehydration?
Increased pulse and respiratory
Dry mucous membranes
Sunken fontanels
Flat jugular vein
Decreased BP (orthostatic)
Decreased urine output
6-9% weight loss
What are s/s of severe dehydration?
Excessive thirst
Decreased BP
Increased HR
Deep and rapid respirations
Flat neck veins
Stopped urine output
Poor skin texture
No tears
10% weight loss
What is management of dehydration
Oral rehydration solution (given in less than 4 hours)
Mild 50mL/kg
Moderate 100mL/kg
IV fluid therapy for severe (expand ECF, meet water and electrolyte requirements, begin oral feedings)
–> CI for hypertonic dehydration
–>20mL/kg for 5-20 minutes
What indicates that rehydration therapy has been effective?
Increased urine output
Normal VS
Cap refill <3s
Alert and oriented
What is the daily maintenance fluid requirements formula?
100mL/kg for the first 10kg, then 50mL/kg for the next 10kg, then 20mL/kg for remainder
