Fluid Electrolytes & Burns w/ ati Exam Questions With 100% Correct Answers

Fluid Electrolytes & Burns w/ ati Exam Questions With 100% Correct Answers 3 major types of dehydration and define each - answer1. Isotonic: = loss of Na and H20 (caused by V&D) Na WNL but hypovolemic shock can happen 2. Hypotonic (hyponatremic): greater loss of sodium than water. -CM's are much worse and shock can occur -serum Na<130 3. Hypertonic (Hypernatremic): NA loss is < water loss. serum Na> 150 shock is less likely but neurological changes can occur What is the main reason infants get more dehydrated than adults? - answerInfants have a greater proportion of ECF ECF is more readily lost than ICF Therefore, infants are at greater risk for dehydration TBW= ______ + ____________ list % TBW for: newborns infants - answerECF + ICF Newborns: 75% Infants: 60-65% Child: 50-60% Adolescents: M (60%) F (50-60%) Adults (70%) Elderly (50%) Infant/Child Risk Factors for Fluid & Electrolyte Imbalance: - answerBody water distribution Greater BSA Higher metabolic rate to support growth Daily fluid requirement greater per kilogram body weight Immature kidneys in children under 2 years of age Risk factors for Developing Fluid Volume Deficit: - answerDecreased intake of fluids and electrolytes Loss of water and electrolytes Whole blood loss, plasma, protein loss Combination decreased intake and losses Fever Minimum urine output by age group: Infants/Toddlers Preschoolers/school age children school age kids/adolescents - answerInfants/Toddlers: >2-3 ml/kg/hr Preschoolers/school age children: >1-2 ml/kg/hr school age kids/adolescents: 0.5-1 ml/kg/hr Daily Fluid Requirements by body weight: <10 kg - answer100mL/kg/day Daily Fluid Requirements by body weight: 10-20 kg - answer1000 mL + 50/kg>10 kg Daily Fluid Requirements by body weight: >20 kg - answer1500 ml + 20 ml/kg>20 kg Assessing Hydration Levels - answerWeight change GI status: vomiting, diarrhea, nutrition Vital signs (*respiratory rate & pattern, *capillary refill, heart rate, blood pressure) Level of Consciousness (alert, irritable, lethargic, unresponsive) General appearance: mucous membranes, tears, skin turgor, & muscle tone Anterior fontanel & eyes (sunken) Urine output (in 8 hrs/in 24 hrs) Major Causes of Dehydration: - answerVomiting & Diarrhea Diabetic ketoacidosis (osmotic diuresis from DKA) Rarely from renal disorders Burns (plasma loss & capillary leak) Mild Dehydration in Children - answerDecreased interest in play irritable, fussy, or restless Increase in hunger or thirst < 4 wet diapers in 24 hours Mucous Membranes are slightly dry Fontanel & eyes are normal Heart rate may be slightly elevated Vital signs normal (blood pressure, pulse, respirations & cap refill) Moderate Dehydration in Children - answerIncreased irritability or lethargy Sunken fontanel and orbits (eyes) few tears Mouth is dry, with sticky saliva Poor skin turgor Appears to be very hungry or thirsty 2-4 wet diapers in 24 hours. Urine is dark with odor & < 1 mL/kg/hr Tachycardia, rapid pulse, decreased blood pressure, increased respirations, delayed cap refill (>2 sec) Severe Dehydration in Children - answerLethargic, confusion, comatose, seizures May not recognize family mem