Pediatric Objectives Exam 2 - Date: August 23rd Unit 5:
Elimination - Gastric & Unit 6: Elimination – Renal 2026
,
, lOMoAR cPSD| 64639315
1. Identify age - related patterns of fluid balance in children.● If the child is
○ 0-10 kg: 100ml/kg
○ 11-20 kg: 1000ml/kg + 50 ml/kg for each kg over 10
○ Over 20 kg: 1,500 ml + 20 ml/kg for each kg over 20
● Daily output:1-2 ml/kg/hour
2. Describe nursing care measures and outcomes related to the care of infants and childrenwith dehydration.
● Occurs when the amount of fluid lost from the body is greater than the amount of fluid taken in.
● Children at greater risk for imbalance b/c they have a greater body surface area, a higher percentage of total body of water, and a
greater potential for fluid loss via the gastrointestinal tract and skin, increased incidences of fevers and upper respiratory infections,
greater metabolic rate, immature kidneys, kidneys w/ decreased ability to concentrate urine and b/c they have an inability to verbalize
thirst.
● Fluid balance – intake and output are approximately the same
● Fluid deficit usually caused by vomiting, diarrhea, hemorrhage ● Fluid balance measured by daily weight and monitoring I&O.
● 3 Types of Dehydration:
○ Isotonic – sodium and water are lost in equal amounts, the most common type, hypovolemic shock is the greatest concern. Serum
sodium will remain in normal limits (130-150 mEq/L)
○ Hypotonic – more sodium than water is lost, physical signs are more severe.
Serum sodium is less than 130 MEq/L.
■ Treat w/
○ Hypertonic – more water than sodium is lost, the most dangerous type, seizures are likely. Sodium serum concentration is greater
than 150 mEq/L
1
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, lOMoAR cPSD| 64639315
■ Treat w/ D5 and ½ 0.45) NS ● Signs and Symptoms:
○ Infants:
■ Sunken fontanelle ○ All Children:
■ Dry skin/ poor skin turgor
■ Tacky or dry mucous membrane
■ Poor perfusion ■ Weight loss
● Big amount of weight loss = major dehydrated → Give a bolus
○ Intraosseous infusion (IO) is the process of injecting medications, fluids, or blood products directly into the
marrow of a bone
■ Decreased blood pressure
■ Tachycardia
■ High hematocrit
● B/c there is not enough fluid in the body ● Diagnosis:
○ Signs and symptoms, lab values
○ Collaborative Care–Medical – IV fluids, determine and treat the cause ● Nursing Interventions for Fluid and Electrolyte
Imbalance:
○ Obtain daily weights (use same scale, same time, and wearing same clothing;
(infants are weight naked and older children only in their underwear) ○ Measure I&Os (weigh diapers for infants)
■ Strict! Everything going in and going out
○ Assess hydration status
○ Obtain lab tests w/ specific gravity, hematocrit, BUN, creatinine, Na, K, and Ca
○ Asses for acid base disturbance
2
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Elimination - Gastric & Unit 6: Elimination – Renal 2026
,
, lOMoAR cPSD| 64639315
1. Identify age - related patterns of fluid balance in children.● If the child is
○ 0-10 kg: 100ml/kg
○ 11-20 kg: 1000ml/kg + 50 ml/kg for each kg over 10
○ Over 20 kg: 1,500 ml + 20 ml/kg for each kg over 20
● Daily output:1-2 ml/kg/hour
2. Describe nursing care measures and outcomes related to the care of infants and childrenwith dehydration.
● Occurs when the amount of fluid lost from the body is greater than the amount of fluid taken in.
● Children at greater risk for imbalance b/c they have a greater body surface area, a higher percentage of total body of water, and a
greater potential for fluid loss via the gastrointestinal tract and skin, increased incidences of fevers and upper respiratory infections,
greater metabolic rate, immature kidneys, kidneys w/ decreased ability to concentrate urine and b/c they have an inability to verbalize
thirst.
● Fluid balance – intake and output are approximately the same
● Fluid deficit usually caused by vomiting, diarrhea, hemorrhage ● Fluid balance measured by daily weight and monitoring I&O.
● 3 Types of Dehydration:
○ Isotonic – sodium and water are lost in equal amounts, the most common type, hypovolemic shock is the greatest concern. Serum
sodium will remain in normal limits (130-150 mEq/L)
○ Hypotonic – more sodium than water is lost, physical signs are more severe.
Serum sodium is less than 130 MEq/L.
■ Treat w/
○ Hypertonic – more water than sodium is lost, the most dangerous type, seizures are likely. Sodium serum concentration is greater
than 150 mEq/L
1
messages.downloaded_by
, lOMoAR cPSD| 64639315
■ Treat w/ D5 and ½ 0.45) NS ● Signs and Symptoms:
○ Infants:
■ Sunken fontanelle ○ All Children:
■ Dry skin/ poor skin turgor
■ Tacky or dry mucous membrane
■ Poor perfusion ■ Weight loss
● Big amount of weight loss = major dehydrated → Give a bolus
○ Intraosseous infusion (IO) is the process of injecting medications, fluids, or blood products directly into the
marrow of a bone
■ Decreased blood pressure
■ Tachycardia
■ High hematocrit
● B/c there is not enough fluid in the body ● Diagnosis:
○ Signs and symptoms, lab values
○ Collaborative Care–Medical – IV fluids, determine and treat the cause ● Nursing Interventions for Fluid and Electrolyte
Imbalance:
○ Obtain daily weights (use same scale, same time, and wearing same clothing;
(infants are weight naked and older children only in their underwear) ○ Measure I&Os (weigh diapers for infants)
■ Strict! Everything going in and going out
○ Assess hydration status
○ Obtain lab tests w/ specific gravity, hematocrit, BUN, creatinine, Na, K, and Ca
○ Asses for acid base disturbance
2
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