DEHYDRATION and BURNS.docx - DEHYDRATION Children have the...

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DEHYDRATION Children have the ability to compensate by pulling water from other places. They have a larger body area surface than adults. More ECF Lose fluids much quicker and the body fluctuates from one type to another. Higher metabolic rate, need more o2 and calories. Kidneys do no compensate well until age 12-18 months. 15-20 minutes from mild dehydration to SEVERE. KNOW NORMAL LEVELS 6-7 heavy diapers is normal output Normal solute = about 300 (body pulls water to dilute large molecules such as glucose) No sugary drinks to hydrate. (Etc. sprite, Gatorade)USE Pedialyte or other hydration drink. ECF – Chief Solute - NA+ 135-145 (SODIUM) ICF- Chief Solute – K+ 3.5-5.0 (POTASSIUM) Maintenance fluids: < or =10kg=100ml/kg; 10-20kg=50ml/kg ; >20kg=20ml/kg) Maintenance fluids for a 22kg child= 10kg x 100 ml = 1000ml; 10kg x 50 ml= 500 ml ; 2kg x 20ml = 40ml = 1540 ml /Total maintenance CAUSES OF DEHYDRATION Vomiting, diarrhea, pyloric stenosis, malabsorption Fever, diabetes mellitus, cystic fibrosis Burns Tachypnea Renal Failure Heart Failure Gastroenteritis accounts for 9% of deaths in children worldwide. Second cause of all deaths globally.
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NURSING CARE/NOTES ROTOVIRUS major cause of diarrhea and dehydration in children. NEVER give K+ in via IV if unable to urinate. Can only excrete potassium in urine. D5 should not be given bolus for dehydration- contains sugar (remember sugar requires water to dilute and pulls it from everywhere.) BOLUS- lactated ringers or Normal Saline (NS) - Isotonic solutions. (Think same as body) Prevent hypovolemic shock Monitor I/O, daily weights, Good hand hygiene, oral hydration, skin integrity-(think diarrhea). Clean and dry skin. Barriers to protect- before skin breakdown. No day care for sick children.
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  • Fall '17
  • Julie Gwin

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