Test 2: Fluid & Electrolyte Balance Flashcards

1
Q

What causes an infant to fluid imbalance?

A

1) greater surface area in relation to body mass
2) greater fluid loss in insensible loss (skin and GI tract)
3) Stomach capacity is smaller
4) GI motility is faster in infants
5) Higher metabolic rate
6) Digestive enzymes usually not present until 4-6 months

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2
Q

What is the formula for calculating fluid needs for a pediatric patient?

A

Output: 1-2 mL/kg hour

Input:

  • Up to 10 kg: 100 mL/kg
  • 10-20 kg: 1000 mL + 50 mL/kg for over 10kg
  • over 20 kg: 1500 mL + 20 mL/kg for over 20 kg
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3
Q

Calculate the percent of dehydration…

A

SUBTRACT child’s weight loss from original weight
DIVIDE by child’s original weight
MULTIPLY by 100 to get a percentage

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4
Q

What are signs of dehydration?

A
  • decreased urine output
  • hard feces
  • diaphoresis
  • tachypnea
  • dry mucus membranes
  • poor skin turgor
  • absence of tears
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5
Q

What are signs of water excess?

A
  • edema
  • elevated venous pressure
  • hepatomegaly
  • slow/bounding puls
  • weight gain
  • lethargy
  • increased spinal fluid pressure
  • CNS: seizures/coma
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6
Q

What are signs of sodium excess?

A
  • intense thirst
  • dry, sticky membranes
  • flushed skin
  • increased temp
  • hoarseness
  • oliguria
  • N/V
  • CNS symptoms
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7
Q

What are signs of water depletion?

A
  • thirst
  • variable temp
  • dry skin & mucous membranes
  • poor skin tugor
  • poor perfusion
  • weight loss
  • fatigue
  • diminished urinary output
  • irritability & lethargy
  • tachycardia
  • tachypnea
  • disorientation
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8
Q

What are signs of potassium excess?

A
  • muscle weakness
  • flaccid paralysis
  • twitching
  • hyperreflexia
  • bradycardia
  • ekg changes
  • v-fib/cardiac arrest
  • oliguria
  • apnea
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9
Q

Define isotonic dehydration:

A

Equal loss of electrolytes and water

most common dehydration in peds

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10
Q

Define hypotonic dehydration:

A

more water than electrolytes

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11
Q

Define hypertonic dehydration:

A

more electrolytes than water
(large loss of water or large intake of electrolytes)
Most dangerous!

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12
Q

Why strict I & O’s on children?

A

Urine output is the single best indicator fluid balance

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13
Q

pH

A

metabolic acidosis

- diarrhea depletes alkaline intestinal secretions

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14
Q

pH > 7.45

Vomiting

A

metabolic alkalosis

- vomiting depletes stomach acid

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15
Q

What type of pathogen?

E. coli, salmonella, shigella, yersinia enterocolitica, capylobacter jejuni, vibrio cholera, C. diff

A

Bacteria

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16
Q

What type of pathogen?

Giardia lamblia, amoeba, intestinal worms

A

Parasite

17
Q

What type of pathogen?

Rotavirus, norwalk virus

A

Virus

18
Q

What virus is the most common cause of severe diarrhea?

A

Rotavirus

19
Q

Rotavirus causes watery diarrhea for __ to __ days.

A

3 to 8

20
Q

How much oral rehydration fluids given for MILD dehydration?

A

50 ml/kg first 4 hrs
Replace volume of emesis
10 ml/kg for each diarrheal stool

21
Q

How much oral rehydration fluids given for MODERATE dehydration?

A

100 ml/kg first 4 hrs

Replace fluids lost

22
Q

How much oral rehydration fluids given for SEVERE dehydration?

A

After adequate hydration is returned with IV fluid therapy,
50-100 ml/kg in 4 hours
10 ml/kg for each diarrheal stool