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CCC Fluid/Electrolyt

CCC Pediatric Fluid and Electrolyte Imbalance

Types of GI disfunctions that affect fluid and electrolytes vomiting/diarrhea; structural/obstructive defects; inflammatory processes; extremely vulnerable to infections
What is the cause of pediatric dehydration? common body disturbance in infants and children, when output exceeds intake, regardless of the cause; result of sensible and insensible losses, lack of oral intake, diabetic ketoacidosis, burns
Factors affecting fluid imbalance in an infant/child more vulnerable to alterations due to greater intake and output relative to size, body adjusts slower to imbalnces due to immature kidneys
ECF, infant to older child/adult larger amount of ECF in an infant. 50% ECF, 50% ICF
Insensible loss 2/3 through the skin, 1/3 respiratory
Body Surface Area (BSA) new born has 2 to 3 times greater surface area than an older child/adult
Basal Metabolic Rate (BMR) Higher than adults due to mass of active tissue
Three Types of dehydration Isotonic, hypotonic, hypertonic
Isotonic Dehydration primary form of dehydration, electrolyte and water deficits are approximately equal, may lead to hypovolemic shock. 0.90% NS
Hypotonic Dehydration excess loss of electrolytes exceeds water deficit. Fluid moves from ECF to ICF. Physical signs are more severe. Na < 130 mEq/L. 0.90% NS and NPO
Hypertonic Dehydration Water loss exceeds electrolyte loss. Fluid moves from ICF to ECF. Most dangerous type of dehydration. Na > 150 mEq/L. 0.45% NS
What happens with cerebral changes from shock? They could be permanent
Early signs of dehydration increased heartrate; postural hypotension, weight loss (mild <5%; moderate up to 10%; severe 10-15%)
Severe signs of dehydration increased heartrate; decreased blood pressure; weak/thready pulse; shock; changes in consciousness; no tears; sunken fontanel; poor skin turgor, low urine output; capillary refill > 2 seconds; thirst; irratablity; dry mucous membranes; no visible pulse
Steps to Maintain Fluid Balance Document accurate I/O on: IV therapy, CHF, major surgery, dehydration, diuretics, diabetes mellitus, corticosteroids, oliguria, renal disease or damage, respiratory distress, chronic lung disease, weigh diaper to determine urine output
PIV therapy site site is associated with development; avoid sites over joints
Infant IV sites hand, wrist, forearm, foot, ankle, scalp (up to 9m)
Child IV site hand, wrist, forearm, avoid foot due to being ambulatory
Venous access site can be hampered by hypovolemic shock or cardiopulmonary arrest
Intraosseus infusion inserted into medullary cavity of the bone and provides rapid, safe and lif-saving alternate route for administration of fluids and medications until intravascular access can be obtained.
Complications of IV therapy Infiltration and vessicant or sclerosing agents
Created by: RJost