Podcast
Questions and Answers
What are additional clinical signs observed in children with dehydration?
What are additional clinical signs observed in children with dehydration?
- Normal sensorium
- Flushed cheeks
- Warm extremities
- Cool mottled extremities (correct)
How often should vital signs be assessed when caring for an ill child?
How often should vital signs be assessed when caring for an ill child?
- Every hour
- Twice a day
- Every 15 to 30 minutes (correct)
- Once a day
What should parents be advised to observe regarding the child's voiding?
What should parents be advised to observe regarding the child's voiding?
- The number of times and how much the child voids (correct)
- The color of the urine only
- The frequency of bowel movements
- The child's appetite
How is capillary filling time affected in severe dehydration?
How is capillary filling time affected in severe dehydration?
What is assessed by pinching the abdominal skin, chest, arm, or leg?
What is assessed by pinching the abdominal skin, chest, arm, or leg?
What is the technique effective for assessing in children of all ages?
What is the technique effective for assessing in children of all ages?
What is important to use when obtaining routine weights of the child?
What is important to use when obtaining routine weights of the child?
What is vital to the assessment of dehydration?
What is vital to the assessment of dehydration?
What is assessed by estimating the time it takes for the blood to return after pinching the skin?
What is assessed by estimating the time it takes for the blood to return after pinching the skin?
What is decreased in relation to the degree of dehydration?
What is decreased in relation to the degree of dehydration?
What is important to do when weighing diapers to measure urine output?
What is important to do when weighing diapers to measure urine output?
What is the primary solute in extracellular fluid (ECF) and determines ECF volume?
What is the primary solute in extracellular fluid (ECF) and determines ECF volume?
Which type of dehydration occurs when water and sodium are lost in approximately equal amounts, leading to a reduction in plasma volume and the risk of hypovolemic shock?
Which type of dehydration occurs when water and sodium are lost in approximately equal amounts, leading to a reduction in plasma volume and the risk of hypovolemic shock?
What is the impact of hypotonic dehydration?
What is the impact of hypotonic dehydration?
What results from water loss in excess of electrolyte loss, causing fluid shifts and greater potential for central nervous system disturbances?
What results from water loss in excess of electrolyte loss, causing fluid shifts and greater potential for central nervous system disturbances?
How is mild dehydration defined in older children?
How is mild dehydration defined in older children?
What is the more accurate means of describing dehydration?
What is the more accurate means of describing dehydration?
What aids in identifying dehydration along with weight, level of consciousness, and heart rate?
What aids in identifying dehydration along with weight, level of consciousness, and heart rate?
Which of the following is a common cause of dehydration in infants and children?
Which of the following is a common cause of dehydration in infants and children?
What is important for identifying dehydration, according to parental reports?
What is important for identifying dehydration, according to parental reports?
What is a clinical manifestation of gastrointestinal dysfunction in children?
What is a clinical manifestation of gastrointestinal dysfunction in children?
Which of the following is a clinical sign of dehydration?
Which of the following is a clinical sign of dehydration?
What is the result of abnormal losses in vomiting or diarrhea when oral intake only partially compensates?
What is the result of abnormal losses in vomiting or diarrhea when oral intake only partially compensates?
What is used to diagnose dehydration?
What is used to diagnose dehydration?
What is the cause of melena in children?
What is the cause of melena in children?
What is the risk associated with isotonic dehydration?
What is the risk associated with isotonic dehydration?
What is the clinical significance of hypoactive, hyperactive, or absent bowel sounds in children?
What is the clinical significance of hypoactive, hyperactive, or absent bowel sounds in children?
What determines extracellular fluid (ECF) volume?
What determines extracellular fluid (ECF) volume?
What is the cause of hematemesis in children?
What is the cause of hematemesis in children?
What is the clinical significance of jaundice in infants and children over 4 weeks of age?
What is the clinical significance of jaundice in infants and children over 4 weeks of age?
What is the cause of encopresis in children?
What is the cause of encopresis in children?
What is the cause of hematochezia in children?
What is the cause of hematochezia in children?
What is the clinical significance of abdominal distension in children?
What is the clinical significance of abdominal distension in children?
What is the cause of dysphagia in children?
What is the cause of dysphagia in children?
What is the cause of nausea in children with GI disorders?
What is the cause of nausea in children with GI disorders?
Which of the following is a compensatory mechanism for maintaining fluid equilibrium?
Which of the following is a compensatory mechanism for maintaining fluid equilibrium?
What is a consequence of fluid losses exceeding the body's ability to sustain blood volume and pressure?
What is a consequence of fluid losses exceeding the body's ability to sustain blood volume and pressure?
What impairs renal compensation in cases of dehydration?
What impairs renal compensation in cases of dehydration?
What is a common manifestation of severe depletion of extracellular fluid (ECF) volume?
What is a common manifestation of severe depletion of extracellular fluid (ECF) volume?
What may be a late sign of shock in infants and young children?
What may be a late sign of shock in infants and young children?
Which clinical signs are useful in predicting dehydration in children?
Which clinical signs are useful in predicting dehydration in children?
When are laboratory data useful in predicting dehydration in children?
When are laboratory data useful in predicting dehydration in children?
What is a common feature of severe depletion of extracellular fluid (ECF) volume?
What is a common feature of severe depletion of extracellular fluid (ECF) volume?
What does therapeutic management involve in cases of dehydration?
What does therapeutic management involve in cases of dehydration?
When is oral fluid administration attempted in cases of dehydration?
When is oral fluid administration attempted in cases of dehydration?
How is oral rehydration management adjusted based on severity of dehydration?
How is oral rehydration management adjusted based on severity of dehydration?
How much oral rehydration solution (ORS) may be given to a child with moderate dehydration?
How much oral rehydration solution (ORS) may be given to a child with moderate dehydration?
Flashcards
Compensatory Mechanisms
Compensatory Mechanisms
Mechanisms that maintain fluid equilibrium by adjusting to losses.
Compromised Circulation
Compromised Circulation
The result of fluid losses exceeding the body's ability to maintain blood volume and pressure, leading to tissue hypoxia and metabolic acidosis.
Impaired Renal Compensation
Impaired Renal Compensation
Decreased blood flow through the kidneys impairs renal compensation, leading to minimal urine formation.
ADH Role in Dehydration
ADH Role in Dehydration
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Shock in Dehydration
Shock in Dehydration
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Low Blood Pressure
Low Blood Pressure
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Clinical Signs of Dehydration
Clinical Signs of Dehydration
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Medical Management of Dehydration
Medical Management of Dehydration
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Oral Rehydration
Oral Rehydration
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ORS for Mild Dehydration
ORS for Mild Dehydration
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ORS for Moderate Dehydration
ORS for Moderate Dehydration
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Study Notes
Pediatric Dehydration: Assessment and Management
- Compensatory mechanisms maintain fluid equilibrium by adjusting to losses, with interstitial fluid moving into the vascular compartment to maintain blood volume and vasoconstriction of peripheral arterioles helping to maintain pumping pressure.
- When fluid losses exceed the body's ability to sustain blood volume and pressure, circulation is compromised, resulting in tissue hypoxia and accumulation of acid metabolites, leading to metabolic acidosis.
- Renal compensation is impaired by decreased blood flow through the kidneys, leading to little urine formation, and increased serum osmolality stimulates ADH to conserve fluid and initiates the renin-angiotensin mechanisms in the kidneys, leading to further vasoconstriction.
- Shock, a common manifestation of severe depletion of extracellular fluid (ECF) volume, is preceded by tachycardia and signs of poor perfusion and tissue oxygenation.
- Low blood pressure may be a late sign of shock in infants and young children, signaling the onset of cardiovascular collapse.
- Clinical signs such as abnormal capillary refill, skin turgor, and respiratory pattern are useful in predicting dehydration in children.
- Laboratory data are useful only when results are significantly abnormal, with urine specific gravity and blood urea nitrogen measurements being unreliable for determining dehydration in children.
- Shock, tachycardia, and very low blood pressure are common features of severe depletion of ECF volume.
- Therapeutic management involves determining the degree and type of dehydration, initial plasma sodium concentrations, serum bicarbonate concentration, and any associated electrolyte and acid-base imbalances.
- Medical management is directed at correcting the fluid imbalance and treating the underlying cause, with oral fluid administration attempted when the child is alert and not in danger, and IV intervention required for severe dehydration.
- Oral rehydration management involves replacement of fluid loss over 4 to 6 hours, provision for maintenance fluid requirements, and adjusting amounts and rates based on body weight and severity of dehydration.
- A mildly dehydrated child may be given 50 mL/kg of oral rehydration solution (ORS), and a child with moderate dehydration may be given 100 mL/kg of ORS, with amounts and rates increased if rehydration is incomplete or if excess losses continue.
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