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ped-fluid & electrol
Fluid and Electrolyte Imbalances
| Question | Answer |
|---|---|
| Infants and Children are more vulnerable to changes in fluid balance because: | 1.Water Balance-larger amount of ECF-rapid water loss 2.Surface Area-larger surface area than adults,allows for more insensible loss 3.METABOLIC RATE:higher bmr’s 4.KIDNEY FX:functionally immature kidney 5.FLUID REQUIREMENTS:greater intake and output |
| Dehydration | Occurs when the total output of fluid exceeds the total intake, regardless of the underlying cause |
| extracellular fluid volume-increased in children-why dehydration is more serious in kids | An infant weighing 7 kg has an extracellular fluid volume of only 1750 ml. They ingest about 700 ml daily and excrete about 700 ml of urine daily. Therefore they exchange about 40% of their volume daily. (700 ml of 1750). |
| 1 ml body fluid = | 1 ml body fluid = 1 gram body weight |
| Assessment of Dehydration-general | Sunken eyes and cheeks, decreased skin turgor,sunken fontanel, sunken abdomen, decreased or no tears,dry mouth or tongue |
| treatment for dehydration | REPLACE THE FLUID LOSS!!!!!!!!!!!! Oral Rehydrating solutions IV fluids Maintain accurate I & 0 |
| What is the maintenance fluid requirement for pts under 10kg? | under 10kg =100ml/kg/day |
| Minimum urine output for all ages | 1ml/kg/hr |
| The ____ surface area to body mass in infants contributes to fluid & electrolyte risk factors | greater |
| ____ basal metabolic rate in children (2-3X adult) contributes to fluid and electrolyte risk factors | higher |
| Immature ____ function contributes to fluid and electrolyte risk factor | kidney |
| greater vulnerability to severe ____ losses contributes to fluid and electrolyte risk factors | electrolyte |
| Risk factor for dehydration - body fluid loss in excess of fluid ____ | gained |
| Risk factor for dehydration is that it is often associated with ____ imbalance | sodium |
| Risk factor: Dehydration is to ____? | diarrhea |
| Mild dehydration is less than ____ ml/kg TBW loss in 48hr period, Up to ____% loss of body weight, or____ water per kg in 24hr period loss | Mild dehydration is less than 50ml/kg TBW loss in 48hr, up to 5% loss of body weight, and 15ml of water per kg loss in 24hr |
| Moderate dehydration is between ____ - ____ ml/kg TBW loss. Between ____% - ____% weight loss of body water. | Moderate dehydration is between 50-90 ml/kg TBW loss and between 5-9% weight loss of body water |
| Severe dehydration is greater than ____ml/kg TBW loss or ____% or higher weight lossSevere dehydration is greater than 100ml/kg TBW loss and 10% or higher weight loss | Severe dehydration is greater than 100ml/kg TBW loss and 10% or higher weight loss |
| mild dehydration manifestations include few ____ stools, ____ color complexion, ____ mucous membranes, ____ unchanged, and ____ behavior | Mild dehydration manifestations include few loose stools, pale complexion, tacky mucous membranes, VS unchanged and normal behavior |
| moderate dehydration manifestations include ____ loose watery stool, irritability, ____ color complexion, ____ mucous membranes, ____ anterior fontanel, ____ pulse, BP ____, capillary refill ___ seconds | Moderate dehydration manifestations include several loose watery stool, irritability, grayish complexion, dry mucous membranes, sligt depression of anterior fontanel, increased pulse, BP normal or lower and capillary refill 2-3 seconds |
| severe dehydration manifestations include letargy, ____ skin, ____ mucous membranes, ____ anterior fontanel, ____ pulse, ____ BP, and capillary refill greater than ____ seconds. | Severe dehydration manifestations include lethargy, mottled skin, parched mucous membranes, sunken anterior fontanel, rapid pulse, lower BP, capillary refill greater than 3 seconds |
| Sodium is normally between ____ - ____. Three classifications of dehydration are ____ ____ ____ | Na 130 - 150. Isotonic, Hypertonic and Hypotonic |
| Isotonic dehydration is ____ loss of Na & Water | Isotonic dehydration is EQUAL loss of Na & H20 |
| Hypertonic dehydration is when water loss is ____ sodium loss? What is this seen in? Na level? | Hypertonic dehydration is when water loss is greater than sodium loss. Seen in fever, burns, high protein with low water diet and not geting enough water. greater than 150 na level |
| Hypotonic dehydration is when water loss is ____ sodium loss. What is this seen in? Na level? | less than, seen in renal failure or excessive water intake. less than 130 Na level |
| Other than sodium, what are three other imbalances associated with dehydration | Potassium, metabolic acidosis and metabolic alkalosis |
| Therapeutic management of mild dehydration includes oraly rehydration solutions ____ ml/kg over ____ hours | 50ml/kg over 4 hrs |
| Therapeutic management of moderate dehydration is ____ ml/kg over ____ hrs whereas severe is ____ | 50-100ml/kg over 4 hrs |
| Severe dehydration therapy: | the child is hospitalized & treated w/ IV fluids. when hydrated properly/or during IV, begin oral rehydration w/100ml/kg over 4 hrs |
| A dehydrated child should not be given ____ to replace fluids because the sugar will cause extra ____ losses | Gatorade extra electrolyte losses |
| Therapeutic management of severe dehydration includes IV fluids of ____ @ ____ml/kg/hr until ___ and ___ return to normal, then ____ ml/kg | Therapeutic managment of severe dehydration includes IV ringer's lactate @ 40ml/kg/hr until pulse and behavior return to normal, then 50-100ml/kg |
| If urine specific gravity is over ____, need more fluid | greter than 1.20. Children don't consentrate urine well |
| With dehydration, which electrolyte is added to an IV after first void | potassium |
| If a child has a hx of vomiting how often is 1 tsp of fluids given until vomiting stops | 1 tsp every 2-3 minutes |
| Nursing interventions for dehydration: measurement of accurate ____, measurement of ____ gravity | Measurement of accurate I&O and specific gravity |
| Nursing interventions of dehydration: ____ fluid therapy, provide ____ intake, ____ care and ____ education | parenteral fluid therapy, provide oral intake, skin care and parental education |
| minimum urine output Infants and toddlers minimum urine output School age/adolescent - - - - - - - - - - - - - - .5 - 1 ml/kg/hour | Infants and toddlers- 2 - 3 ml/kg/hour Preschool/young children- 1 - 2 ml/kg/hour School age/adolescent- .5 - 1 ml/kg/hour |
Created by:
jewelln
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