Flashcards in Exam #2 Fluids and Electrolytes Deck (107)
What are some differences between adults and children?
-Their fluid requirements
- Ability to manage fluids
- the smaller and younger we are, the more water and saline is in our body.
- Longer GI tract in relation to body size.
- Immature kidneys
- Higher metabolic rate due to increased respirations and HR
Immature immune system, results in more fevers and increases metabolic rate more
TNA is one of the most routine surgeries for children
Under general anesthesia
takes about 15 - 20 min
Normal for blood tinged vomit, as long as not bright red and excessive.
have to pee and drink before you go home
Adults and Adolescents are made up of _____% normal saline.
Infants are made up of ____% normal saline.
Little premies in the NICU are made up of _____% normal saline.
The other important thing to remember is where the water is located.
Our fluid is located in the extracellular space and our intracellular space.
Extracellular fluid is
blood within the vessels
Synovial fluid ect….
any water that is outside of the cells
It is EASY to lose
Intracellular Fluid is
water that is inside of the cell.
It is protected by the cellular membrane.
It is harder to lose and tends to stay where it is supposed to stay.
sodium – 135 – 145 mEq/L
potassium and magnesium –
K+ -- 3.5 – 5.0 mEq/L
Mag – 1.5 – 2.2 mEq/L
How much of an infants body weight is ECF?
By the time they reach adolescent age, they will have only 20% of their body weight as extracellular.
This is why infants lose fluid volume quicker because the majority of their fluid volume is ECF.
ECF is easier lost because it is NOT protected by the cell membrane.
How much of an infants body weight is ICF?
It is important to remember which electrolytes compose the water because dehydration is directly related to where our sodium and chloride is.
Extracellular fluid has the sodium
Most of Intracellular fluid is mainly potassium
This does not mean that it does not pass the cell membrane.
What makes kids so special?
they are composed of more water
the smaller they are, the more water they are made up of
they have different vital signs, smaller they are the faster they breathe.
babies have immature kidneys
What are the 2 ways that we lose water?
sensibile water loss
Insensible water loss
What is sensible water loss?
peeing and pooping.
Things that can be measured
What is insensible water loss?
It is what we lose through skin and respirations.
How much insensible water loss occurs through the skin?
How much insensible water loss occurs through respirations?
So for insensible water loss in a child that breathes faster than an adult…..they are going to lose more water.
also, there is more body surface area in smaller babies available compared to the amount of our weight the smaller the baby is.
This makes a huge difference in preterm babies.
They have a lot of skin compared to their core muscle and fat.
Where as if you get a big guy, they have less skin compared to their core muscle and fat.
We get more insensible water loss the smaller the baby is
The thing about babies and infants is they have premature kidneys.
This means that they are not as great at concentrating their urine as much as it needs to be concentrated.
They also pee more than bigger guys
Because of their fast heart rate and because they are growing so fast they have a higher metabolic rate.
This causes them to lose more water than adults.
Then we have GI tract, so in relationship to their body size, they have a longer GI tract, and it is faster.
so they tend to poop more than adults. Especially when they are infants.
The other thing to remember, especially with infants and the younger population, is that they have an immature immune system.
So they get sick more often,
they have fevers more
which increases metabolic rate and causes more fluid loss.
Things that cause water loss in an children and infants:
Could be multiple….
Higher skin surface area
Longer GI Tract
Immature Immune system (FEVERS)
Higher metabolic rate from increased RR and HR
So to maintain this hydration, this equality of intake and output, our body has a wonderful system that it produces.
When we get thirsty, it means that we have had a little bit of fall in our blood volume.
Which is a rise in blood osmolarity.
When there is a rise in our blood osmolarity…what happens next?
It stimulates the pituitary to produce ADH.
What does ADH do?
It makes us stop peeing and holds onto water.