PEDS-altered Fluid and Electrolytes

Question 1

Fluid volume loss for:
Mild dehydration____
Moderate Dehydration_____
Severe Dehydration________

Answer 1

Mild = 5% of fluid volume loss

Moderate = 5-9% of fluid volume loss

Severe = >10% of fluid volume loss

Question 2

List three things that can cause a fluid imbalance in an infant

Answer 2

1) Respiratory Illness
2) stomach virus (vomiting, diarrhea)
3) burns

Question 3

Pediatric clients have increased need for fluids due to the following (4) areas:

Answer 3

1) Greater ECF volume (until about 2yrs old)
2) Body Surface Area (5x greater than others)
3) Basal Metabolic Rate is increased
4) Immature Kidney Function

Question 4

How to calculate fluid replacements for dehydrated pediatric clients

Answer 4

100ml/kg -for first 10kg
50ml/kg - for second 10kg
20ml/kg - for remainder of weight in kg
DIVIDE TOTAL AMT BY 24 HOURS = ml/hr

Question 5

TWO CAUSES OF HYPONATREMIA

Answer 5

GASTROENTERITIS

WATER OVERLOAD

Question 6

Normal Pediatric Sodium Lab Value

Answer 6

130-150

Question 7

Moderate dehydration

*Skin color_________

Answer 7

Grey

Question 8

_______ and _______ are valuable indicators of fluid balance

Answer 8

fontanels

weight loss/gain

Question 9

Severe dehydration...
Skin Color\_\_\_\_\_\_\_\_
Mucous Membranes\_\_\_\_\_\_\_
Blood pressure is \_\_\_\_\_\_\_\_\_
Pulse is \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 9

Skin Color is mottled
Lips=dry
Tongue = furrowed

Blood pressure is VERY LOW
Pulse is TACHYCARDIC

Question 10

Moderate dehydration

Blood pressure is _________ Pulse is _________

Answer 10

blood pressure is slightly elevated

Pulse is elevated

Question 11

Three (3) types of dehydration

Answer 11

Isotonic (ISONATREMIC)- equal loss of water and electrolytes

Hypotonic (HYPONATREMIC) - Primarily a loss of electrolytes (NA <135)

Hypertonic (HYPERNATREMIC) - Primarily a loss of water (NA >145)

Question 12

symptoms of dehydration in pediatric clients

Answer 12

INFANTS-irritable, restlessness, lethargic, sleepy

Question 13

TRUE or FALSE

Infants lose more fluid through the kidneys because immature kidneys are les able to conserve water than are adult kidneys

Answer 13

TRUE

Question 14

Stages (3) of Dehydration Management?

Answer 14

1) Initial
* *BOLUS OF ISOTONIC FLUID (20-30ML/KG)
* *ASK IF THE PATIENT IS GETTING BETTER

2) Replace Deficits, maintenance fluids

3) Final Phase
* *ORAL REHYDRATION/FEEDING (Pedialyte-then if can keep food down- feed with bland diet)

Question 15

Three (3) levels of sodium deficiency

Answer 15

• MILD—120-130
• MEDIUM — 114-120
• *SEVERE —LESS THAN 114

Question 16

Insensible water loss accounts for ____ to_____ ml per day

Answer 16

300-400 ml per day

Question 17

Insensible water loss occurs through____________

Answer 17

skin and lungs