Pediatric Dehydration
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Questions and Answers

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?

  • 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?

  • 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?

    <p>More than 4 seconds</p> Signup and view all the answers

    What is assessed by pinching the abdominal skin, chest, arm, or leg?

    <p>Capillary filling time</p> Signup and view all the answers

    What is the technique effective for assessing in children of all ages?

    <p>Dehydration</p> Signup and view all the answers

    What is important to use when obtaining routine weights of the child?

    <p>The same scale each time</p> Signup and view all the answers

    What is vital to the assessment of dehydration?

    <p>Accurate measurements of fluid intake and output</p> Signup and view all the answers

    What is assessed by estimating the time it takes for the blood to return after pinching the skin?

    <p>Capillary filling time</p> Signup and view all the answers

    What is decreased in relation to the degree of dehydration?

    <p>Body weight</p> Signup and view all the answers

    What is important to do when weighing diapers to measure urine output?

    <p>Approximately 1 g wet diaper weight equals 1 mL urine</p> Signup and view all the answers

    What is the primary solute in extracellular fluid (ECF) and determines ECF volume?

    <p>Sodium</p> Signup and view all the answers

    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?

    <p>Isotonic dehydration</p> Signup and view all the answers

    What is the impact of hypotonic dehydration?

    <p>Severe impact on physical signs</p> Signup and view all the answers

    What results from water loss in excess of electrolyte loss, causing fluid shifts and greater potential for central nervous system disturbances?

    <p>Hypertonic dehydration</p> Signup and view all the answers

    How is mild dehydration defined in older children?

    <p>3-5% body weight lost</p> Signup and view all the answers

    What is the more accurate means of describing dehydration?

    <p>Acute loss in milliliters per kilogram of body weight</p> Signup and view all the answers

    What aids in identifying dehydration along with weight, level of consciousness, and heart rate?

    <p>Skin elasticity</p> Signup and view all the answers

    Which of the following is a common cause of dehydration in infants and children?

    <p>Increased renal excretion</p> Signup and view all the answers

    What is important for identifying dehydration, according to parental reports?

    <p>Fluid intake, urine output, diarrhea, and emesis</p> Signup and view all the answers

    What is a clinical manifestation of gastrointestinal dysfunction in children?

    <p>Projectile vomiting</p> Signup and view all the answers

    Which of the following is a clinical sign of dehydration?

    <p>Tachycardia</p> Signup and view all the answers

    What is the result of abnormal losses in vomiting or diarrhea when oral intake only partially compensates?

    <p>Dehydration</p> Signup and view all the answers

    What is used to diagnose dehydration?

    <p>Percentage of body weight lost</p> Signup and view all the answers

    What is the cause of melena in children?

    <p>Lower GI tract bleeding</p> Signup and view all the answers

    What is the risk associated with isotonic dehydration?

    <p>Hypovolemic shock</p> Signup and view all the answers

    What is the clinical significance of hypoactive, hyperactive, or absent bowel sounds in children?

    <p>Evidence of intestinal motility issues</p> Signup and view all the answers

    What determines extracellular fluid (ECF) volume?

    <p>Sodium</p> Signup and view all the answers

    What is the cause of hematemesis in children?

    <p>Upper GI tract bleeding</p> Signup and view all the answers

    What is the clinical significance of jaundice in infants and children over 4 weeks of age?

    <p>Yellow discoloration associated with liver dysfunction</p> Signup and view all the answers

    What is the cause of encopresis in children?

    <p>Involuntary overflow of incontinent stool</p> Signup and view all the answers

    What is the cause of hematochezia in children?

    <p>Lower GI tract bleeding</p> Signup and view all the answers

    What is the clinical significance of abdominal distension in children?

    <p>Protuberant contour associated with various causes</p> Signup and view all the answers

    What is the cause of dysphagia in children?

    <p>Abnormalities in the neuro-muscular function of the pharynx or esophagus</p> Signup and view all the answers

    What is the cause of nausea in children with GI disorders?

    <p>Delayed gastric emptying</p> Signup and view all the answers

    Which of the following is a compensatory mechanism for maintaining fluid equilibrium?

    <p>Movement of interstitial fluid into the vascular compartment</p> Signup and view all the answers

    What is a consequence of fluid losses exceeding the body's ability to sustain blood volume and pressure?

    <p>Tissue hypoxia and metabolic acidosis</p> Signup and view all the answers

    What impairs renal compensation in cases of dehydration?

    <p>Decreased blood flow through the kidneys</p> Signup and view all the answers

    What is a common manifestation of severe depletion of extracellular fluid (ECF) volume?

    <p>Tachycardia</p> Signup and view all the answers

    What may be a late sign of shock in infants and young children?

    <p>Low blood pressure</p> Signup and view all the answers

    Which clinical signs are useful in predicting dehydration in children?

    <p>Abnormal capillary refill</p> Signup and view all the answers

    When are laboratory data useful in predicting dehydration in children?

    <p>When results are significantly abnormal</p> Signup and view all the answers

    What is a common feature of severe depletion of extracellular fluid (ECF) volume?

    <p>Tachycardia</p> Signup and view all the answers

    What does therapeutic management involve in cases of dehydration?

    <p>Determining the degree and type of dehydration</p> Signup and view all the answers

    When is oral fluid administration attempted in cases of dehydration?

    <p>When the child is alert and not in danger</p> Signup and view all the answers

    How is oral rehydration management adjusted based on severity of dehydration?

    <p>Amounts and rates are increased for severe dehydration</p> Signup and view all the answers

    How much oral rehydration solution (ORS) may be given to a child with moderate dehydration?

    <p>100 mL/kg</p> Signup and view all the answers

    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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    Description

    Test your knowledge on pediatric dehydration with this quiz. Explore assessment and management strategies, including compensatory mechanisms, clinical signs, laboratory data, and therapeutic management. Dive into oral rehydration and IV intervention techniques for different levels of dehydration.

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