Fluid & electrolyte differences

If children get sick, if theyre not drinking then they can die really fast so it is important
Enzymes are not created until 4-6 months
Gas and abdominal distention are a problem with children
Two most common problem that causes dehydration/reason children become dehydrated:
vomiting & diarrhea
The skin surface (BSA) is more insensitive to water through the skin. Children has more
BSA than adults
High daily fluid requirements & little fluid volume reserved b/c they have no places to
store it yet; brain & skin takes up more area
Reasons for dehydration
Kidneys are immature and are not functioning properly
Difficulty regulating electrolytes; Children has problems with sodium, K+ & Ca+
Young children may not be thirsty and feel dehydrated (check skin turgor on chest)
IV for dehydration
Fluid volume deficit
Isotonic: sodium & water loss of equal proportion
Hypotonic: more sodium than water loss (severe vomiting & diarrhea, burns, renal
disease)
o Treated with an IV LR and NS
Hypertonic: seen with diabetes insipidus
o Treated with electrolyte
Acute gastroenteritis
Definition: inflammation of the intestines (GI tratct) is an illness of fever, diarrhea, & or
vomiting caused by an infectious virus, bacteria or parasite
It has a short onset on children
Diarrhea has mucus and blood
Causes watery stool, lethargic, dry mouth
Viral
o Rotavirus causes the foul smelling diarrhea
Diet restriction and hospitalized
Noravirous: 2nd most common in the U.S.
% of dehydration measurement
Mild diarrhea
Moderate diarrhea
Severe diarrhea
% of dehydration
Practice problem: 22kg/25kg
Practice problem: child wt. 38kg; after vomiting & diarrhea child wt. 37kg
o Percent of dehydration: 1kg/38kg = 0.026 (2.6%)
o The fluid loss is 1kg
Age s/s
Sunken fontanels and dark ring under eyes
Check for pallor, check for skin turgor if theyre not peeing at all & dry mucus
membranes
AGE physical exma
AGE physical exam: sunken belly isnt good
High bowel sounds = diarrhea; low bowel sounds = constipation
TX
No vomiting after 12 hours then they can be fed
Give fluids (IV)
BRAT diet: bananas, rice, apple sauce, dry toast
Avoid spicy/greasy food
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