Flashcards in Dehydration and Fluid Management Deck (49)
How does the total body fluid compare in children to adults?
It is higher in children
What % of the body is made up of water at birth?
What % of the body is made up of water by adulthood?
Where is water distributed throughout the body?
- Intracellular space
- Extracellular space
What proportion of water is distributed in the intracellular space?
What proportion of water is distributed in the extracellular space?
Where is water distributed within the extracellular space?
What proportion of extracellular water is interstitial?
What proportion of extracellular water is extracellular?
What does the distribution of water between the intracellular and extracellular spaces depend on?
The pressure and osmotic gradients between them
What is dehydration?
Loss of water and electrolytes
What might cause children to become dehydrated?
- Reduced oral fluid intake
- Additional fluid losses
- Increased insensible losses
- Loss of normal fluid retaining mechanisms
What might cause reduced oral fluid intake?
- Reduced appetite due to illness
- Sore throat
What might cause additional fluid losses?
What might cause increased insensible losses?
- Increased sweating
What might cause a loss of the normal fluid-retaining mechanisms?
- Capillary leak
- Permeable skin of premature infants
- Increased urinary losses secondary to renal disease
Why are infants and young children more prone to dehydration than older children and adults?
- Body made up of more water
- High surface area in relation to their height or weight
- Relatively high evaporative water losses
- Higher metabolic rate, so higher turnover of water and electrolytes
- Rely on others to give them fluids
Does dehydration itself cause death?
How can dehydration lead to death?
It can cause shock, which can lead to death
When does shock occur in dehydration?
When there is rapid loss of at least 25% of intravascular volume that is not replaced at a similar rate from the interstitial space
Can shock occur without dehydration?
What does the treatment of shock require?
Rapid administration of intravascular volume of fluid
What should be true of fluid administered to treat shock?
It should approximate in electrolyte content to plasma
How should dehydration without shock be treated?
Gradual replacement of fluids
What should the electrolyte content of the fluid used to treat dehydration resemble?
The electrolyte content of the fluid that is lost, or to the total body electrolyte content
What can be used to objectively measure the total body fluid changes?
How can percentage dehydration be calculated?
(weight before - weight after ) / weight before = % dehydration
What is the limitation of calculating percentage dehydration?
Pre-illness weight is rarely available in emergency situations
What can be used to assess dehydration when pre-illness weight is not available?
Clinical symptoms and signs