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