Pediatric Hydration/Dehydration

Flashcards for reviewing pediatric hydration and dehydration concepts.

Pediatric patients are more vulnerable to what kind of imbalances?

Fluid and electrolyte imbalances

At birth, what percentage of a child's body weight is composed of water?

A greater percentage, which declines with age

How does the amount of extracellular fluid in infants compare to adults?

Infants have more extracellular fluid

Why do the brain and skin occupy more space in infants regarding fluid balance?

Both are rich in interstitial fluid

Why do pediatric patients have little fluid volume reserve?

The extracellular fluid is exchanged daily

Through which two body systems do infants and young children experience more insensible fluid loss?

Skin and respiratory tract

What effect does a higher metabolism have on fluid needs in children?

Leads to greater fluid needs

How does the GI tract length in children compare to adults in relation to height?

It is greater for height in children

Which organ's immaturity affects compensatory mechanisms related to fluids and electrolytes in children?

The kidney

At what age are children unable to conserve or excrete water and solutes effectively?

Children < 2 years

What two electrolytes do children under 2 years have difficulty regulating?

Na+ and Ca+

How does the renal response to high solute loads in children compare, especially in the first year of life?

It is slower and less developed

What is the general guide for normal hourly urine output for a pediatric patient?

1-2 mL/kg/hour

List three ways insensible water loss occurs.

Sweat & evaporation from skin, loss through respiratory tract, normal stool

What is the typical daily insensible water loss in mL/m2?

300 mL/m2 per day

Name one cause of an increased fluid requirement related to medical equipment.

Use of phototherapy or overhead warmer

Name two causes of an increased fluid requirement due to excessive fluid loss.

Vomiting, diarrhea, or increased insensible losses

For every 1°C elevation in temperature above 37°C, how much more fluid is needed per kg per hour?

0.42 mL/kg/hour

Name one cause of a decreased fluid requirement in a pediatric patient related to the heart.

Congestive heart failure

What conditions involving fluid retention would indicate a decreased fluid requirement?

Cardiac, pulmonary, or renal fluid retention

What central nervous system condition would warrant a decreased fluid requirement?

Cerebral edema or potential for it

What is the daily potassium requirement for a pediatric patient with normal kidneys?

2-3 mEq/kg per day

What critical nursing action must be confirmed before administering the first IV solution with potassium?

The patient needs to have voided at least once

Describe the mental status of a child with mild dehydration.

Alert

Describe the fontanelles of an infant with moderate dehydration.

Sunken

How do the eyes appear in a child with mild dehydration, if assessed?

Normal

Describe the oral mucosa of a child with severe dehydration.

Dry

What is the skin turgor like in severe dehydration?

Tenting

What happens to the heart rate in moderate dehydration?

May be increased

What happens to blood pressure in severe dehydration?

Normal, progresses to decreased

Describe the extremities of a child with severe dehydration.

Cool, mottled, or dusky, significantly delayed capillary refill

What is the urine output for a child with moderate dehydration?

What are the three types of dehydration?

Hypotonic, Isotonic, and Hypertonic

What is not recommended for managing dehydration regarding milk or formula?

Lactose free milk or half-strength formula

Are homemade rehydration solutions recommended for managing dehydration?

No

What type of fluids should be used for mild to moderate dehydration?

Oral rehydrating fluids (ORF)

How much ORF should be given for mild dehydration in the first four hours?

50 mL/kg

How much ORF should be given for moderate dehydration in the first four hours?

100 mL/kg

What should a nurse do if a child is vomiting while receiving ORF for dehydration?

Continue with ORF even if vomiting

For severe dehydration, what two types of IV fluids are indicated?

Ringer’s lactate or dilute saline

When administering IV fluids for severe dehydration, how should the total amount be distributed over a 24-hour period?

Half of the total in the first 8 hours, and the remainder in the next 16 hours

When should a child resume a normal diet after rehydration?

As soon as the child is rehydrated

Why are BRAT diets not recommended when resuming a normal diet after rehydration?

Too high of carb load and not enough protein for healing

If a child has diarrhea, how should concentrated fluids like juice be given?

Diluted 1:1 with water or ORF

Why should concentrated fluids be diluted for a child with diarrhea?

Concentrated fluids can worsen the condition due to the osmotic effect

What type of beverages should be avoided for children with diarrhea?

Carbonated Beverages

Can children with diarrhea typically still have a regular diet?

Yes, unless a certain food makes it worse

What is a key monitoring task for a child with diarrhea who is not currently dehydrated?

Watch closely to assess for dehydration

List one common topic for discharge teaching regarding dehydration.

Signs of dehydration (or Types of fluids to give, How to give fluids, When to call the doctor, When to start regular diet, Review child’s normal hydration needs, Calculating fluid maintenance for parents)

What is an important reason to resume a normal diet as soon as a child is rehydrated?

To speed recovery and assure adequate calories for health and healing