N307 Week 5 Fluid electrolyte imbalance, renal and
genitourinary dysfunction, cerebral dysfunction and CNS
malformations questions with correct answers
Do infants have larger or smaller extracellular fluid volume versus older
children and adults? Correct Answer-Larger
Sensible fluid loss Correct Answer-loss that is perceived or is
measurable. (wound drainage, GI tract, urine)
Insensible loss Correct Answer-Water lost thru the skin by sweating or
being under heat lamp
Electrolyte Normal Levels in Children Correct Answer-K+: 3.7-5.0
Na: 134-143
Ca: 8.7-10.7
Mag: 1.6-2.4
Arterial PO2: 80-100
Arterial PCO2: 32-48
Arterial bicarb: 18-25
Isotonic Dehydration Correct Answer-Proportionate loss of fluid and
sodium
Extracellular loss
,Hypotonic dehydration Correct Answer-•Greater loss of sodium than
water
•Extracellular shift to intracellcular to compensate
•Examples: prolonged vomiting, diarrhea, renal disease, burns
Hypertonic dehydration Correct Answer-•Greater water loss than
sodium
•Intracellular shift into extracellular to compensate
•Examples: diabetes insipidus, fluid volume overload
mild dehydration Correct Answer-5% weight loss
Moderate pulse
Moderate dehydration Correct Answer-6-9% fluid loss
Severe dehydration Correct Answer-10% or greater fluid loss. fast and
weak pulses
Oral rehydration therapy Correct Answer-•Recover patient with IV fluid
resuscitation, oral rehydration therapy, change environmental factors
when applicable
•Oral rehydration best for mild or moderate loss
Fluid volume excess Correct Answer-•Too much fluid in vascular and
interstitial compartment.
, •Serum sodium normal
•Due to aldosterone (Adrenal tumors, CHF, Liver cirrhosis, Chronic
renal failure
•May also be attributed to low socioeconomic families that over dilute
formula and fluid overloaded children
Edema and care management Correct Answer-•Assess for: Weight gain,
increased input vs output, infusion rate and ensure patient is not being
overloaded
•Monitor for skin integrity
•Provide diuretics and pharmacological interventions as appropriate
Hypernatremia Correct Answer-Caused by water deprivation OR
Diabetes Insipidus
S/S: Thirsty, decreased urinary output, ALOC, lethargy, seizures
Treatment: Fluid resuscitation (hypotonic or isotonic), oral replacement
therapy
Hyperkalemia Correct Answer-Caused by Increased intake through IV
fluids, replacement, blood products
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