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24 Cards in this Set

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Caloric requirement
Premies = 110-120 kcal/kg/day
Term infants = 100-110 kcal/kg/day
1 y/o = 1000 kcal/day
+ 1 yr = + 100 kcal
Shock in different ages
Systolic BP of:
1 mo-1 yr = <70mm
1-10 yrs = <70 mm + (2xage)
>10 yrs = <90 mm
Delayed capillary refill
is >2 seconds
indicates poor skin perfusion
doughy skin indicates
hypertonic deydration
("salty bread")
seizures when Na+<
120
best signs of dehydration (4)
1 - wt loss
2 - lethargy
3 - skin turgor
4 - dryness of mucous membranes (palpated)
Rehydration: replacement fluids
body wt (kg) x (% dehydration) x 10
Maintenance fluids
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
Normal urine output for child (& oligouria)
1-2mL/kg/h
(0.5)
how fast to give fluids?
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
Breast fed babies have __ glucose levels than bottle-fed
lower
(but suffer no damage b/c more ketones)
Hypoglycemia values
AGE HYPOGLYCEMIA
whole blood glu plasma glu
</=24h </=40 </= 45
24-72h </=45 </= 50
>72h </=55 </=60
Keep umbilical arterial PaO2 at
60-80 mmHg
Metabolic acidosis
4.2% sodium bicarbonate at 4 mL/kg at 1 mEq/kg/min
Correct low BP with
-NS
-Ringer's lactate
-whole blood
Hypocalcemia in infants
<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
DO NOT mix Ca++ glutonate w/
sodium bicarbonate
ABG in septic shock
pH pO2 pCO2 BE
low N low low
anion gap
( [Na+] ) − ( [Cl−]+[HCO3−] )
Normal = 8-16
Tx for acute SIADH
restrict fluids
Electrolyte consequences of vomiting
lose H+ -->pH up --> want to retain in kidneys --> use exchanger -->lose Na+

now: low Na+, N K+, N pH
Hypokalemia causes
-flattened T wave
--> can have pulseless VT, torsades de pointes
hyperkalemia causes
nausea, fatigue, muscle weakness
peaked T waves, prolonged QRS
tx: Ca++ chloride IV, insulin w/glu, NaHCO3,loop diuretics
serum osmoloality formula
Na++x2 + (BUN//3 + glu/18)