Dehydration - Fluid & Electrolytes Flashcards Preview

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Flashcards in Dehydration - Fluid & Electrolytes Deck (42):
1

Difference between children & adults r/t fluid & electrolytes

children can enter into dehydration much quicker

2

what makes children more susceptible to dehydration - physiological differences (5)

larger body surface area in relationship to their weight
increased baso-metabolic rate
inability to concentrate urine (urine is very diluted)
higher respiratory rate - (child resp. rate = 40)
under 3, body fluids aren't stored as efficiently (stored in extracellular compartment) - insensible fluid lose

3

urine specific gravity increases or decreases in a child with dehydration

increases (eg: 1.020)
normal range of urine specific gravity (1.003-1.030)
***THE HIGHER THE DRYER***

4

what is an insensible fluid lose

fluid lost at the surface

5

infants

no

6

when does posterior fontanel close

8 weeks

7

when does anterior fontanel close

12-18 months

8

a sunken fontanel is consistent with dehydration, t or f

true

9

% of extracellular vs intracellular fluids by age (e/i)

infant 40/40
toddler (3 yr) 30/40
adult 20/40

10

water balance is regulated by

ADH - anti-diuretic hormone = acts on kidney tubules to reabsorb h20

11

formula for fluid bolus when dehydrated

20ml/kg of isotonic solution infused over 4 hours
reevaluate dehydration symptoms (diaper, eyes, fontanel)

12

what does ORS stand for?

oral re-hydration solutions (pedialyte)

13

Cardiac symptoms r/t dehydration

increase in pulse rate (hr); then a decrease with later stage of dehydration
weak/thready pulse

14

Blood pressure r/t dehydration

bp drops - late sign - severe dehydration
resp failure - hypo-volemic shock

15

fluid overload s/s

cough
moist breath sounds
water intoxication

16

fluid for children is a delicate balance, t or f

true

17

***95% of your potassium (k) is excreted via your***

***kidneys***
Don't add K to iv fluids until wet diaper if oliguria or anuria. Too much K can build up in intravascular fluid.

18

Too much K (hyperkalemia) can lead to

arrhythmia's
cardiac arrest

19

Potassium values

PANIC (7.0 mEq/L)
infant 3.6-5.8
child 3.5-5.5
adult 3.5-5.3

20

classified hyperkalemia with value above

5
can lead to heart arrhythmia (can be seen on ekg)

21

hypokalemia value k is less than

22

risk for hypokalemia

child on diuretics
ingesting lg amounts of ASA

23

A child w/an NG tube should have what monitored closely

potassium levels

24

Dehydration types (3)

hypertonic dehydration (hypernatremic) = more fluid loss than sodium (sodium >150)
isonatremic dehyrdation (isotonic) = lose equal parts water and sodium (sodium levels in norm. range)
hyponatremic/hypotonic = more sodium loss than water, generally sodium is

25

most frequent dehydration we will run into

isotonic/isonatremic dehydration

26

body weight and dehydration

10% body loss = severe dehydration
5% body loss = mild dehydration
5-9% body loss = moderate dehydration

27

norm sodium levels

135-148 mEq/L

28

kids with cystic fibrosis experience which type of dehydration - particularly in summer

hyponatremic/hypotonic - loose more salt than water; salt tablets given to replace the loss
taste salty

29

2 different ways to classify dehydration

weight
serum sodium levels

30

most abundant cation & chief base of blood

sodium

31

children with hypernatremia are almost always

dehydrated

32

re-hydration solutions are made up of what?

75-90 mEq Na+ per liter - electrolyte solution

33

for severely dehydrated patients bolus with what?

20ml/kg of isotonic solution over 20 minutes (bolus)

34

for re-hydration follow this formula (after bolus)

calc. maint. fluids add additional fluids based on weight loss as follows:
50ml/kg for mild
100ml/kg for moderate
150ml/kg for severe
2/3 of fluids within 8 hours of admission

35

BRAT diet is not recommended t or f

true

36

If no urine output teach parent to

call the Dr

37

if child is admitted to the hospital with dehydration what should be part of your care plan

daily weights - same time/scale each day
accurate i/o

38

daily weights is the best indicator of what

fluid status

39

never give k in an iv push, t or f

true

40

whats d5 1/2?

dextrose 5%, .45 Na+

41

whats d5 1/3?

dextrose 5%, .33 Na+

42

whats d5 1/4?

dextrose 5%, .225 Na+