Peds Fluids, Ivf And Electrolytes

Front 1

Caloric requirement

Back 1

Premies = 110-120 kcal/kg/day
Term infants = 100-110 kcal/kg/day
1 y/o = 1000 kcal/day
+ 1 yr = + 100 kcal

Front 2

Shock in different ages

Back 2

Systolic BP of:
1 mo-1 yr = <70mm
1-10 yrs = <70 mm + (2xage)
>10 yrs = <90 mm

Front 3

Delayed capillary refill

Back 3

is >2 seconds
indicates poor skin perfusion

Front 4

doughy skin indicates

Back 4

hypertonic deydration
("salty bread")

Front 5

seizures when Na+<

Back 5

120

Front 6

best signs of dehydration (4)

Back 6

1 - wt loss
2 - lethargy
3 - skin turgor
4 - dryness of mucous membranes (palpated)

Front 7

Rehydration: replacement fluids

Back 7

body wt (kg) x (% dehydration) x 10

Front 8

Maintenance fluids

Back 8

100 ml/kg/24h for first 10 kg
50 ml/kg/24h for 2nd 10 kg
20 ml/kg/24h for 3rd 10 kg
20 ml/kg/24h for 4th 10 kg
10 ml/kg/24h for 5th 10 kg
10 ml/kg/24h for 6th 10 kg

Front 9

Normal urine output for child (& oligouria)

Back 9

1-2mL/kg/h
(0.5)

Front 10

how fast to give fluids?

Back 10

1 - hypertonic dehydration
-give evenly over 24h to avoid cerebral edema
2 - iso and hypotonic "
-1/2 replacement in 1st 8h, rest in next 16h

Front 11

Breast fed babies have __ glucose levels than bottle-fed

Back 11

lower
(but suffer no damage b/c more ketones)

Front 12

Hypoglycemia values

Back 12

AGE HYPOGLYCEMIA
whole blood glu plasma glu
</=24h </=40 </= 45
24-72h </=45 </= 50
>72h </=55 </=60

Front 13

Keep umbilical arterial PaO2 at

Back 13

60-80 mmHg

Front 14

Metabolic acidosis

Back 14

4.2% sodium bicarbonate at 4 mL/kg at 1 mEq/kg/min

Front 15

Correct low BP with

Back 15

-NS
-Ringer's lactate
-whole blood

Front 16

Hypocalcemia in infants

Back 16

<8.0 in term or <7.0 in premie (mg/dL)
Often asymp
-may cause jitters, twitching, convulsions
-Chvostek sign and Trousseau sign rare in neonates
Give Ca++ glutonate 2 mL/kg IV

Front 17

DO NOT mix Ca++ glutonate w/

Back 17

sodium bicarbonate

Front 18

ABG in septic shock

Back 18

pH pO2 pCO2 BE
low N low low

Front 19

anion gap

Back 19

( [Na+] ) − ( [Cl−]+[HCO3−] )
Normal = 8-16

Front 20

Tx for acute SIADH

Back 20

restrict fluids

Front 21

Electrolyte consequences of vomiting

Back 21

lose H+ -->pH up --> want to retain in kidneys --> use exchanger -->lose Na+

now: low Na+, N K+, N pH

Front 22

Hypokalemia causes

Back 22

-flattened T wave
--> can have pulseless VT, torsades de pointes

Front 23

hyperkalemia causes

Back 23

nausea, fatigue, muscle weakness
peaked T waves, prolonged QRS
tx: Ca++ chloride IV, insulin w/glu, NaHCO3,loop diuretics

Front 24

serum osmoloality formula

Back 24

Na++x2 + (BUN//3 + glu/18)