peds exam 2 fluid/electrolytes and GI, hepatic
objectives
1. total body water is made up of + .: ICF + ECF
2. primary electrolyte inside cells is...: K+
3. primary electrolyte outside cells is...: Na+
4. ECF includes three types of fluid::
intravascular interstitial fluid (surrounds cells)
transcellular (CSF, pleural, synovial fluid)
5. dehydration occurs when: total output of fluids exceeds total input of
fluids
6. describe the three types of dehydration:: Hypotonic - primarily a
deficit of electrolytes
Hypertonic - primarily a loss of water
Isotonic - overall loss of volume (equal loss of water and electrolytes).
**Accounts for 80% of dehydration in humans**
7. hypotonic is aka hypo .
in serum Na.:
hyponatremic H20 < Na
decrease
8. hypotonic presents with what MS? is shock common?: lethargy/coma
yes shock is common
9. hypertonic is aka hyper .
in serum Na.: hypernatremic.
H20 > Na
increase
10.hypertonic presents with what MS? is shock common?: very irritable
no, shock is uncommon
11. isotonic is aka iso .
in serum Na.:
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
isonatremic H20 = Na
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
normal level
12.isotonic presents with what MS? is shock common?: irritable/lethargic
shock can occur in severe cases
13. therapeutic interventions for dehydration
what are not good examples to use?: replace fluid losses!!
--> first line is oral rehydration solution (ORS) = even vomiting does
not contradict this
DO NOT use high sugar fluids such as popsicles and juice -- bcz they
increase water into colon
14.what are sensible and insensible water losses of the body?: sensible
= urine, stool
insensible = sweat, respiratory tract
15. IVF may be used to rehydrate and maintain fluid balance w goal of what?
: initial goal of expanding ECF and then replacing any electrolyte deficits
16.5 pediatric considerations for dehydration: dehydration is a high
risk for young children d/t several factors --->
immature renal fxn including decreased ability to concentrate urine
and inefficient excretion >
fast RR and high metabolic rate (more waste to breakdown
and excrete) greater body surface area to fluid volume
different proportions of intra and extracellular water
17.5 tx and conditions that may cause fluid/electrolyte imbalance:
radiant warmer
photothera
py burns
surgery
fever
18.what to assess for hydration status?: fontanelles
(sunken?) mucous membranes
eyes (tear production, sunken?)
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
skin - turgor and cap
refill BP
tachycardia
tachypnea/ Dyspnea; hyperventilation possible to compensate for
metabolic acido- sis
neuro status, behavioral assessment
19.what should you monitor to track hydration status?: intake
output (weigh dry diaper and subtract from wet weight; 1mL urine = w 1
urine) weight of pt
20.how do you calculate daily maintenance fluids for kids? what are the
4 steps?: 1.Calculate child's weight in kg
2.100mL/kg for first 10kg of body
weight 3.50mL/kg for second 10kg of
body weight 4.20mL/kg for
remaining body weight
21.calculate daily maintenance fluids for a 77lb child: Child weighing 77lbs
• 77/2.2 = 35kg
• 100 x 10 for 1st 10kg = 1000
• 50 x 10 for 2nd 10kg = 500
• 20 x 15 for remaining weight = 300
• 1000+500+300 = 1800mL/24hr
•
1 cup = 8oz = 240mL; 1800mL = 7.5 cups per day
22.most common form of dehydration in peds is what?: isotonic
23.patho of stomach muscle: what are 4 layers?: mucosa
(inner) submucosa
muscular
is serosa
24.A & P differences in infant GI: •Stomach capacity
• Decreased hydrochloric acid & different mix of pancreatic juices
• Lower esophageal sphincter laxity
• Full GI tract immature until 2 years
• Liver function immature until 1 year
• higher basal metabolic rate
• Storage of glycogen (glucose) for energy
objectives
1. total body water is made up of + .: ICF + ECF
2. primary electrolyte inside cells is...: K+
3. primary electrolyte outside cells is...: Na+
4. ECF includes three types of fluid::
intravascular interstitial fluid (surrounds cells)
transcellular (CSF, pleural, synovial fluid)
5. dehydration occurs when: total output of fluids exceeds total input of
fluids
6. describe the three types of dehydration:: Hypotonic - primarily a
deficit of electrolytes
Hypertonic - primarily a loss of water
Isotonic - overall loss of volume (equal loss of water and electrolytes).
**Accounts for 80% of dehydration in humans**
7. hypotonic is aka hypo .
in serum Na.:
hyponatremic H20 < Na
decrease
8. hypotonic presents with what MS? is shock common?: lethargy/coma
yes shock is common
9. hypertonic is aka hyper .
in serum Na.: hypernatremic.
H20 > Na
increase
10.hypertonic presents with what MS? is shock common?: very irritable
no, shock is uncommon
11. isotonic is aka iso .
in serum Na.:
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
isonatremic H20 = Na
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
normal level
12.isotonic presents with what MS? is shock common?: irritable/lethargic
shock can occur in severe cases
13. therapeutic interventions for dehydration
what are not good examples to use?: replace fluid losses!!
--> first line is oral rehydration solution (ORS) = even vomiting does
not contradict this
DO NOT use high sugar fluids such as popsicles and juice -- bcz they
increase water into colon
14.what are sensible and insensible water losses of the body?: sensible
= urine, stool
insensible = sweat, respiratory tract
15. IVF may be used to rehydrate and maintain fluid balance w goal of what?
: initial goal of expanding ECF and then replacing any electrolyte deficits
16.5 pediatric considerations for dehydration: dehydration is a high
risk for young children d/t several factors --->
immature renal fxn including decreased ability to concentrate urine
and inefficient excretion >
fast RR and high metabolic rate (more waste to breakdown
and excrete) greater body surface area to fluid volume
different proportions of intra and extracellular water
17.5 tx and conditions that may cause fluid/electrolyte imbalance:
radiant warmer
photothera
py burns
surgery
fever
18.what to assess for hydration status?: fontanelles
(sunken?) mucous membranes
eyes (tear production, sunken?)
, peds exam 2 fluid/electrolytes and GI, hepatic
objectives
skin - turgor and cap
refill BP
tachycardia
tachypnea/ Dyspnea; hyperventilation possible to compensate for
metabolic acido- sis
neuro status, behavioral assessment
19.what should you monitor to track hydration status?: intake
output (weigh dry diaper and subtract from wet weight; 1mL urine = w 1
urine) weight of pt
20.how do you calculate daily maintenance fluids for kids? what are the
4 steps?: 1.Calculate child's weight in kg
2.100mL/kg for first 10kg of body
weight 3.50mL/kg for second 10kg of
body weight 4.20mL/kg for
remaining body weight
21.calculate daily maintenance fluids for a 77lb child: Child weighing 77lbs
• 77/2.2 = 35kg
• 100 x 10 for 1st 10kg = 1000
• 50 x 10 for 2nd 10kg = 500
• 20 x 15 for remaining weight = 300
• 1000+500+300 = 1800mL/24hr
•
1 cup = 8oz = 240mL; 1800mL = 7.5 cups per day
22.most common form of dehydration in peds is what?: isotonic
23.patho of stomach muscle: what are 4 layers?: mucosa
(inner) submucosa
muscular
is serosa
24.A & P differences in infant GI: •Stomach capacity
• Decreased hydrochloric acid & different mix of pancreatic juices
• Lower esophageal sphincter laxity
• Full GI tract immature until 2 years
• Liver function immature until 1 year
• higher basal metabolic rate
• Storage of glycogen (glucose) for energy
