Fluid Management In Children Flashcards Preview

Jason's MD3 Paeds > Fluid Management In Children > Flashcards

Flashcards in Fluid Management In Children Deck (25):
1

what is maintenance fluid?

To replace insensible losses
Allows excretion of excess solute load in urine

2

What is resuscitation fluid?

Replacement fluid for losses (blood, vomit, sweat)

3

Diarrhoea, lose what?

K+, can lose a lot

4

Major cation intra cellularly?

K+

5

Major cation extracellular ly?

Na+

6

What is tonicity?

Concentration of solutes that exerts an osmotic force across a membrane

7

Does Glucose exert osmotic force?

Nope, usually not, no tonic force

8

Normal Values of osmolality?

270-295mmol/kg

~280

9

Role of sodium in fluids?

Most important ECF cation
Maintains plasma tonicity and ECF volume
USUALLY reflects water balance.

10

Problems with fluids in children that come up?

Hyponatraemia
Encephalopathy

11

ADH does what?

Water retention at kidneys
Moves from ECF to ICF

12

Purpose of stress response?

Glucagon gets mobilized

13

What is natriuresis?

Losing Na+ in urine

14

What causes natriuresis? Mechanism?

ANPeptide
Stretch at atrium
Due to volume loading

15

Why children at risk for hyponatraemia?

Large brain:, increase ICP

16

When do seizures occur in adults/children?

Children :Na:

17

THings to consider when prescribing fluid?

Volume/rate
Na
K
Energy

18

How much energy in 5% dextrose. 1000ml?

200cal

19

Paediatric IV maintenance Study (PIMS)

Plasma-lyte vs. 0.45% NaCL in 5%D
Less ppl became hyponatraemic on Plasmalyte

20

Stress response causes?

Water retention

21

Remember what when give fluids to kids?

Kids eat and drink early. Need to adjust

22

give What fluids to really sick kids?

Relative fluid restriction
2/1/1. Or 2/3 maintenance
Plasma review
daily electrolytes
Reduce once drinking

23

High risk groups that retain more fluid? How to maintain?

Meningitis
Neonate S
Craniotomy-facial/neurosurg/Major surg
Anyone who needs full maintenance

Daily electrolytes

24

Role of dextrose solution?

1. Prevent hypoglycaemia, prev. Ketosis
2. To give free water into a peripheral vein: prev. Haemolysis

25

When give TPN?

When not eating or drinking for more than a few days. Liver glycogen stores depleted.