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23 Cards in this Set
- Front
- Back
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Def. of dehydration?
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Total output exceeds total intake by more than the insensible losses.
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Prediposing factors for dehydration in infants?
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Surface area allows for greater fliud loss than an adult. Infant metabolic rate greater than adult. Immature kidney function. Water 80% of body weight at birth.
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What are the diagnostic studies to test for dehydration?
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Urine specific gravity, electrlytes, and AGB.
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Underlying causes of dehydration
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Diarrhea, vomiting, sweating, burns, dietary.
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Isotonic Dehydration
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Electrolyte and fliud loss equal. Major fliud loss is ECF. Serum sodium level is normal.
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Hypotonic dehydration
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Electrolyte loss greater than water. Water shifts from extracellular to intracellular space. Serum sodium is low.
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Hypertonic dehydration
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Water loss is greater than electrolyte loss. Fliud shifts from ICF to ECF.
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IV fliud replacement duration for:
Hypertonic Isotonic Hypotonic |
Hypertonic-over 48 hours (needs to be slow)
Isotonic and hypotonic- over 24 hours. (1/2 over 8 hours, 1/2 over next 16 hours.) |
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Daily maintenance fliud requirements for first 10 kg body weight, 2nd 10 kg body weight, and remaining body weight.
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100ml/kg for 1st 10kg, 50ml/kg for 2nd 10kg, and 20ml/kg for remaining body weight.
Divide by 24 to get hourly rate. |
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Example: 23 kg child gets how much maintenance fluids?
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100ml x 10 kg= 1000ml
50 ml x 10kg= 500ml 20ml x 3kg= 60ml Total= 1560ml hourly rate= 65ml/hour |
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Fluid replacement total
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Figure out maintenance and multiple by 1.5.
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Vomiting etiology
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Infection, drug ingestion, food allergy, obstruction, increased ICP, motion sickness, stress, self-induced.
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Vomiting diagnostics
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Labs- electrolytes (Ka), CBC, urine specific gravity, osmolarity, obstruction series, CT or US.
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Vomiting treatment
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Antiemetics (Zofran), diet, fliud replacement.
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Diarrhea etiology
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Enteropathic organisms, dietary, meds, infections, inflammatory bowel disease, emotional.
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Diarrhea treated with antibiotics means?
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C-diff.
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Test diarrhea for?
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rotavirius, c-diff, SSYC, girardia.
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Diarrheal disturbances:
Gastroenteritis Enteritis Colitis Entercolitis |
Gastroenteritis: inflammation vomiting/diarrhea. Small intestine.
Enteritis-just diarrhea. Small intestines. Colitis-just diarrhea. Large intestine. Entercolitis-both small and large intestines. |
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5 types of diarrhea
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Acute, acute infectious gastroenteritis, chronic, intractable diarrhea of infancy r/t formula, chronic nonspecific diarrhea.
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Etiology of diarrhea
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Rotavirus, salmonella, giardia, crytosporidium, clostridium difficile (c-diff), campylobacteriosis (lake swimming, animal feces), antibiotic therapy, E-coli.
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Salmonella
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Food poisoning, highest in children under 5 years, contaminated food and water (poultry) rapid onset- nausea, vomiting, diarrhea (may show blood and mucus), self-limited, antibiotics in bacteremia, report to local health department.
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Are antidiarrheals recommended for children?
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Not generally. Never give to kids under 4.
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Constipation in newborn:
First meconium should pass within? |
24 to 48 hours of life. If not, assess for Hirschsprung disease, hypothyroidism, meconium plug, meconium ileus.
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