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From Flashcardlet > Pediatric Electrolytes > Flashcards

Pediatric Electrolytes Flashcards

0
Q

Insensible water loss per unit or body weight is

A

Significantly higher in infants and children

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1
Q

What represents a true difference between fluid and electrolytes of a child compared to those of adult?

A

Infants and children have a relatively greater body surface area than adults.

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2
Q

Normal urine output for infants

A

1-2cc/kg

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3
Q

Why is regulation of homeostatic changes associated with fluids and electrolytes in infants and children is much slower than adults?

A

Differences in the chemical composition of the body

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4
Q

Why are children more susceptible to dehydration states than adults?

A

They have a larger portion of total body fluid in the extracellular space

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5
Q

Why do you not give infants extra bottles of water?

A

They can’t concentrate

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6
Q

Isotonic dehydration

A

Normal, give NS or lactated ringers

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7
Q

Hypotonic dehydration

A

Low / loss of sodium compared to water

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8
Q

What happens to cells in hypotonic

A

Sodium goes into cells and extracellular space shrinks

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9
Q

What are hypotonic solutions

A

D5W / 1/2 NS / .33 NS

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10
Q

Hypertonic dehydration

A

High sodium

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11
Q

When do you use D5W in hypertonic

A

For cerebral edema and for short periods of time

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12
Q

One type of dehydration in children is isotonic dehydration , which occurs when

A

Loss of sodium and water are equal

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13
Q

Mild dehydration

A

5% of total body weight lost

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14
Q

Moderate dehydration

A

6-9% body weight lost

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15
Q

Severe dehydration

A

10% and greater of body weight lost

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16
Q

Assessment data to determine dehydration

A

% body weight lost, level of consciousness, low blood pressure, pulse rapid, renting skin turgor, dry mucous membranes, low urine output, thirst, cap refill > 4 sec, rapid resp, sunken fontanels

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17
Q

Fluid req. 1-10 kg

A

100ml/kg

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18
Q

Maintenance fluid req 11-20 kg

A

1000ml plus 50 mL/kg for each kg over 10

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19
Q

Maintenance fluid requirement >20

A

1500 mL plus 20 mL/kg for each kg over 20

20
Q

How do you determine how much fluid is in a diaper?

A

Weight dry and wet diaper

21
Q

How do we calculate fluid loss from weight loss?

A

Daily weight

22
Q

Hyperkalemia acronym

A

MURDER. Muscle weakness, Urine decreased, Resp distress, Decreased cardiac contractility & arrhythmias, EKG changes, and Reflexes (flaccid or hyperreflexia)

23
Q

Sign of hyponatremia

A

Cerebral edema, increased urine output

24
Q

Hypernatremic acronym

A

FRIED. Fever, Restless, Increase fluid retention (increase BP), Edema, Decreased urine output/dry mouth

25
Q

What is the daily fluid requirement for an infant weighing 5 kg

A

500 mL

26
Q

What does it indicate if the urine SG is 1.005?

A

Normal

27
Q

If a child is weighed and had lost 4 kg of weight…how many mL of fluid loss would this be?

A

4L (1 kg lost = 1 L lost)

28
Q

Oral replacement therapy to mild to moderate dehydration

A

1st 2-4 hours give 50 mL/kg oral

29
Q

Oral replacement therapy with severe dehydration

A

IV fluids with bolus then oral fluids

30
Q

What would be the most appropriate rehydration for a 3 year old child that has lost 6% BW, has a rapid pulse and is slightly oliguric?

A

120-240 mL of ORT for each diarrhea stool or emesis

31
Q

Guideline for fluid replacement for some with diarrhea/emesis < 10 kg

A

Give 60-120ml per diarrhea/emesis

32
Q

Guidelines for fluid replacement with diarrhea/emesis with someone weighing >10kg

A

120-240 mL per diarrhea/emesis

33
Q

When BP becomes high for a kid, how much body fluid have they already lost?

A

25%

34
Q

Appropriate choices for ORT

A

Pedialyte, rehydralyte, cereal-based, infalyte, home made solution (8tsp sugar & 1 T salt to 1 L of cool water)

35
Q

Inappropriate ORT

A

Water (decrease Na) soft drinks, fruit juices, broths (Na), sports drinks

36
Q

What diet should be initiated after fluids diet

A

BRAT bananas, rice, apple, toast

37
Q

The nurse would instruct the family to contact a health professional when what occurs?

A

The child’s ursine output decreases

38
Q

Practice alerts

A

Use small bags of fluids; always use infusion pumps; set pressure limits; double check your calculations; check IV frequently; monitor for signs and symptoms of fluid vol overload

39
Q

Gastroenteritis diseases

A

Rotavirus, Norwalk, shigella, salmonella, giardia, acute/chronic diarrhea

40
Q

What are gastroenteritis diseases mainly due to?

A

Lack of hand washing

41
Q

Priorities with diarrhea

A

1) determine cause of diarrhea
2) prevent spread of infection
3) rehydrate the child
4) manage fever associated with diarrhea

42
Q

Hypocalcemia symptoms acronym

A

CATS. Convulsions, Arrhythmias, Tetany, Spasms (resp strider)

43
Q

Signs of hypercalcemia

A

Increased urine output, constipation, nausea

44
Q

Normal calcium levels for peds

A

4.3-5.3

45
Q

What are infants receiving IV therapy especially vulnerable to?

A

Fluid overload

46
Q

What do you monitor when giving kids potassium?

A

Urine output

47
Q

What assessment finding would lead a nurse to suspect dehydration in a neonate?

A

Urine output below 1ml/hr

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