Peds Final Review - Fluid and Electrolytes

Question 1

DIARRHEA

Increased number or decreased consistency of stools

Answer 1

Causes:

• -Infections: bacterial, viral
• -Malabsorption problems
• -Inflammatory diseases
• -Dietary factors

Can lead to:

• -Dehydration
• -Metabolic acidosis
• -Shock

Question 2

DIARRHEA

Nursing Assessment:

–Occurs usually in infants

–History of exposure to pathogens, contaminated food, dietary changes, day care

Answer 2

Signs of dehydration:

• -Poor skin turgor
• -Absence of tears
• -Dry mucous membranes
• -Wt. loss ( 5 – 15% or more)
• -Depressed fontanel
• -Decreased Urine output, –increased specific gravity

Lab signs of acidosis:
–Serum pH

Question 3

DIARRHEA

Nursing Diagnosis:

Answer 3

Diarrhea related to …..

Risk for deficient fluid volume related to ……

Question 4

DIARRHEA

Nursing Interventions:

–Assess hydration status and vital signs frequently

–Monitor intake and output

–Cleanse diaper area after each stool with mild soap and water. Avoid use of baby wipes.

–Do not take temp rectally

–Rehydrate as prescribed with fluids and electrolytes

–Calculate IV hydration to include maintenance and replacement fluids

Answer 4

Add potassium to IV fluids only with adequate urine output

Collect specimens to aid in diagnosis of cause

Check stools for pH, glucose, and blood

Administer antibiotics as prescribed

Check urine for specific gravity
Institute careful isolation precautions; wash hands

Teach home care of child with diarrhea:
–Provide child with oral rehydration solution

–Child may temporarily need lactose-free diet

–Children should not receive antidiarrheals such a Imodium

–Do not give child grape juice, orange juice, apple juice, cola, or ginger ale. These solutions have high osmolality

Question 5

BURNS

Answer 5

Burns are the second leading cause of accidental death in children under 15 (after automobile accidents)

It is estimated that 75% of burns are preventable

Question 6

BURNS

Children under age 2 have a higher mortality rate due to:

Answer 6

Greater central body surface area.

• – In a child under 2, a greater part of their body surface area is concentrated in the head and trunk compared to the adolescent and adult.
• —As a result, the younger child is more likely to have serious effects from burn to the trunk and head.

Greater fluid volume (proportionate to body size)

Less effective cardiovascular responses to fluid volume shifts

Question 7

BURNS

In childhood, a partial-thickness burn is considered a major burn if it involves more than 25% of the body surface

Answer 7

A full-thickness burn is considered major if it involves more than 10% of body surface

Question 8

BURNS

Because of the changing proportions of the child, esp. the infant, the Rule of Nines cannot be used to assess the percent of burn.

Answer 8

As assessment tool such as the Lund-Browder chart, which takes into account the changing proportions of the child, should be used.

Question 9

BURNS

Fluid needs should be calculated from the time of the burn.

Answer 9

The formula for calculating fluid replacement and maintenance is based on child’s body surface area and should include volume for burn losses and maintenance.

Question 10

BURNS

Adequacy of fluid replacement is determined by evaluating urinary output.

Answer 10

Specific gravity should be less than 1.025