4.6 Pediatric Dehydration Stuff - Tice

Tice

dehydration symptoms in adults and children

headache

dizzy

tired

dry mouth

thirst

cranky

dark colored pee

dry skin

constipation

dehydration symptoms in infants

fever

no tears

unusual tiredness

dry mouth

no wet diapers

MILD dehydration s/s in infants:

1. UOP

2. weight loss

3. capillary refill

1. normal or decreased

2. 3-5%

3. 2-3 seconds

MODERATE dehydration s/s in infants:

1. pulse

2. systolic BP

1. slightly increased

2. normal to low

MODERATE dehydration s/s in infants:

1. UOP

2. weight loss

3. thirst

1. marked decrease

2. 6-10%

3. moderate

MODERATE dehydration s/s in infants:

1. mucosa

2. tears and fontanelle

3. eyes

1. dry

2. reduced

3. deep set

MODERATE dehydration s/s in infants:

1. skin turgor

2. skin temperature

3. capillary refill

4. behavior

1. decreased

2. cool

3. >5 seconds

4. irritable

SEVERE dehydration s/s in infants:

1. pulse

2. systolic BP

3. UOP

1. rapid and weak

2. shock

3. anuric (no peepee)

SEVERE dehydration s/s in infants:

1. weight loss

2. thirst

3. mucosa

1. 9-15%

2. intense

3. extremely dry

SEVERE dehydration s/s in infants:

1. tears

2. eyes

3. skin turgor

4. skin temperature

1. absent

2. markedly sunken

3. tenting/increased

4. cool/ mottling

SEVERE dehydration s/s in infants:

1. fontanelle

2. capillary refill

3. behavior

1. sunken

2. >8 seconds

3. irritable / lethargic

A 1 year old patient who weighed 10 kg prior to illness is now 9.4 kg. She has had three stools and two episodes of emesis.

1. what is her severity?

2. what is her % dehydration / severity?

3. what is the fluid deficit?

1. moderate dehydration

2. 6%

3. 0.6 L

mild dehydration classification:

1. infant % severity

2. child % severity

1. 1-5%

2. 1-3%

moderate dehydration classification:

1. infant % severity

2. child % severity

1. 6-9%

2. 4-6%

severe dehydration classification:

1. infant % severity

2. child % severity

1. >10%

2. >6%

severe (shock) dehydration classification:

1. infant % severity

2. child % severity

1. >15%

2. >9%

oral rehydration therapy is only if the patient is _____ dehydrated

mild or moderate

oral rehydration therapy is NOT indicated if the pt has _____ dehydration

severe or shock

oral rehydration therapy commercial product example

pedialyte

what should be discouraged from giving in oral rehydration therapy?

juices

ginger ale

sodas

sports drinks

broths

how to dose (equation) for mild dehydration oral rehydration therapy?

(50 mL / preillness weight) + [(10 mL / preillness weight) x (# of stools + emesis)] = volume given

how to dose (equation) for moderate dehydration oral rehydration therapy?

(100 mL / preillness weight) + [(10 mL / preillness weight) x (# of stools + emesis)] = volume given

when should mild vs moderate dehydration be reassess if giving ORT?

1. mild: q2h

2. moderate: q1h

ORT should be given over _____

3-4 hrs

ORT should be given over 3-4 hours in _____ increments every _____

5 mL q1-2 mins

if ORT is given as it should be, then the pt is receiving about _____ mLs per hour

150-300

for testing purposes: when to stop giving ORT?

when the ENTIRE volume has been given

Pediatric advanced life support (PALS):

when should CPR be initiated if a pt has cardiopulmonary arrest

within 10 seconds