Fluid Electrolytes & Burns w/ ati
3 major types of dehydration and define each - ANS1. 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? - ANSInfants 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 - ANSECF + 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: - ANSBody 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: - ANSDecreased 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 - ANSInfants/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 - ANS100mL/kg/day
Daily Fluid Requirements by body weight:
10-20 kg - ANS1000 mL + 50/kg>10 kg
Daily Fluid Requirements by body weight:
>20 kg - ANS1500 ml + 20 ml/kg>20 kg
Assessing Hydration Levels - ANSWeight 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: - ANSVomiting & Diarrhea
Diabetic ketoacidosis (osmotic diuresis from DKA)
Rarely from renal disorders
Burns (plasma loss & capillary leak)
Mild Dehydration in Children - ANSDecreased 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)
3 major types of dehydration and define each - ANS1. 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? - ANSInfants 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 - ANSECF + 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: - ANSBody 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: - ANSDecreased 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 - ANSInfants/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 - ANS100mL/kg/day
Daily Fluid Requirements by body weight:
10-20 kg - ANS1000 mL + 50/kg>10 kg
Daily Fluid Requirements by body weight:
>20 kg - ANS1500 ml + 20 ml/kg>20 kg
Assessing Hydration Levels - ANSWeight 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: - ANSVomiting & Diarrhea
Diabetic ketoacidosis (osmotic diuresis from DKA)
Rarely from renal disorders
Burns (plasma loss & capillary leak)
Mild Dehydration in Children - ANSDecreased 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)
