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14 Cards in this Set
- Front
- Back
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How does body water distribution change during age?
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Birth- 80% body water
6 month- 70% 1 year to adult- 60% |
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How does water loss occur during increased body temperature?
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For each degree centigrade, an additional 10 mL/kg/day of water loss.
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How is maintenance fluid calculated for a child?
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Less than 10 kg: 4 mL/kg/hour
10-20 kg: 1000 mL plus 2 mL/kg/hour for every kg over 10 > 20 kg: 1500 mL plus 1 mL/kg/hour for every kg over 20 |
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What features of history would indicate dehydration?
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Prolonged inadequate intake
Diabetes melitus Diabetes insipidus Diuretics Vomiting/ diarrhea Fever Burns |
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How is dehydration assessed on physical exam?
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General appearance
Cap refill Pulse Blood pressure Weight loss Anterior fontanelle Tearing Mucosa Turgor Skin mottling |
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How is dehydration assessed on lab evaluation?
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Serum bicarbonate
BUN/creatinine |
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How is dehydration managed?
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Determine severity
Type of dehydration Treat shock Develop rehydration plan- oral vs. IV |
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What are indications for oral rehydration? what are contraindications?
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Less than 10% of dehydration.
Altered consciousness, unwilling to drink, vomiting, abdominal distension, decreased bowel sounds, severe electrolyte abnormalities. |
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What are the three phases of IV rehydration?
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Treat shock within 30 minutes.
Replace intravascular volume in 8 hours. Replaces intracellular volume over 16 hours. |
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What type of fluid is given for hypernatremic dehydration? Isonatremic? Hyponatremic?
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Hypernatremic: 1/4 NaCl
Isonatremic: 1/3 NaCl Hyponatremic: 1/3 NaCl |
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Why does hypernatremic dehydration need to be rehydrated slowly?
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Rehydrating too quickly can result in extracellular water shift into the brain and cause herniation.
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What are common causes of hypernatremia dehydration?
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Diabestes mellitus/ insipidus
Osmotic diuretics Burns Restricted water access too much salt |
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What are common causes of hyponatremia dehydration?
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Inappropriate rehydration
SIADH Cardiac failure Nephrotic syndrome Cirrhosis Psychogenic Child abuse GI sodium losses Renal sodium loss Diuretic Adrenal insufficiency Cystic fibrosis |
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What is the treatment for SIADH?
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Fluid restriction
Treat underlying cause Treat with hypertonic saline if seizures or coma |
