Dehydration - Fluid & Electrolytes Flashcards Preview

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Flashcards in Dehydration - Fluid & Electrolytes Deck (42)
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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