-
-
-
ecf breaks into
interstitial and intravascular(plasma)
-
fluid req 3-10kg wt
100ml/kg
-
fluid req 11-20 kg wt
1000ml plus 50ml/kg for each kg above10 kg
-
fluid req >20kg
1500 ml plus 20ml/kg for each kg above 20 kg
-
pts with decreased fluid req
CHF, patent ductus arteriosus(shuts closed after birth, harder to shut if fluid overloaded, 1st couple days can fluid restrict), renal dysfunction, increased ICP
-
Na electrolyte req
2-6 mEq/kg/d
-
K electrolyte req
1-3 mEq/kg/d
-
common causes of dehydration in peds
gastroenteritis, GI sx occuring w other disease states, infnts cannot respond independently
-
signs of dehy in peds
decreased UOP, tachy, sunken fontanelles, increased capillary refill time, altered mental status, decreased level of cons, hypotension (late sign)
-
mild dehydration
3-5%, normal HR, BP, fontanelle, slightly dry mucus, warm, normal capilary reill, slight inc in thirst slight dec in UOP
-
mod dehy
6-9%, increase HR, normal BP, sunken font, dry mucus, delayed capillary refill, mod inc in thirst, less than 1ml/kg/hr UOP
-
severe dehy
10% or greater, inc HR, slight dec or normal BP, sunken fontanelle, dry mucus, cool, mottled extremities, sign inc in thirst, minimal UOP
-
oral rehydration
consider in mild-mod dehy, vomiting is not a CONTRA, 50-100ml/kg over a three to four hour period
-
contraindications to oral rehydration
hemodyn instability, serum Na<120 or >160, acute surgical abdomen, altered mental status, severe respiratory distress, ileus, continued vomiting despite attempts at oral rehydration(can admit to hospital)
-
IV rehydration (5)
- 1. assess degree of dehydration
- 2, calc replacement fluids
- 3. calc main fluids
- 4.calculate ongoing losses
- 5. determine how quickly to admin the replacement and main fluids
|
|
