Dehydration and Gastroenteritis PEDs Exam Solution Manual Already Passed
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Dehydration and Gastroenteritis
Institution
Dehydration And Gastroenteritis
Dehydration and Gastroenteritis PEDs Exam Solution Manual Already Passed
Past medical history - Answers - why did they come into the office? what are the symptoms? vomiting, diarrhea, fever?
- what does the vomit look like? how old is the child? are they experiencing growth problems?
Physical ...
Dehydration and Gastroenteritis PEDs Exam Solution Manual Already Passed
Past medical history - Answers - why did they come into the office? what are the symptoms? vomiting,
diarrhea, fever?
- what does the vomit look like? how old is the child? are they experiencing growth problems?
Physical examination - Answers - might be pale, fontanel might be sunken in if less than 18 months,
assess bowel sounds
- urine output should be asked about and try ti quantify it: how many times did they go and how wet are
their diapers
Fluid balance principles - Answers - your body is made up of both intracellular and extracellular fluid
- these together equal total body water
where are these fluids ECF located - Answers - ECF is located between cells and in the lymph and plasma
ECF compared to ICF - Answers - ECF is lost more readily than ICF and because there is more ECF to lose,
dehydration occurs commonly especially in younger children
Sodium and chloride - Answers - since these predominate in ECF, with fluid loses comes electrolyte
imbalances
- if you lose a lot of water you are losing a lot of sodium
Body surface area in children - Answers - they have a larger body surface area leading to more insensible
fluid loss by 2/3 vaporation and 1/3 respiration from breathing and RR
GI tract in children - Answers - children also have an abnormally large GI tract leading to increased
sensible fluid loss via vomiting and sweating
Pediatric basal metabolic rate - Answers - the metabolism the body has in order for it to function is
much higher to promote growth in children because they use their calories much faster
What does the higher BMR then lead to? - Answers - increased insensible fluid losses and more water is
needed to excrete increased metabolic waste, needing the kidneys to work hard
Immature kidneys - Answers - they are inefficient at excreting waste products, concentrating and
diluting urine, and conserving and excreting sodium
Infants and formulas - Answers - less able to handle solute free liquid
- they become over hydrated with diluted down formula
- become dehydrated with over concentrated formula
, - EDUCATE these parents about mixing correclty
factors affecting fluid losses - Answers - Radiant warmers and photosensitivity: nothing but diaper
- skin defects and breakdowns/burns: keep it moist to prevent fluid loss
- fever: treat this to prevent fluid loss
- increased RR: treat and find underlying cause
- elevated room temp: remove blankets, lower temp
How can we make clients with fluid restrictions more comfortable? - Answers - by doing things such as
giving them a lollipop, Popsicle, sucking a wet cloth, putting it in a small cup and giving more frequently,
syringe, lip balm
access to the fluid when on fluid restrictions - Answers - you can never leave the fluid bedside with
children, you should schedule their drinks
NPO - Answers - if they are nothing by mouth make sure they have some type of diet ordered
Mental status in dehydration - Answers - mild: alert
- moderate: alert to listless
- severe: alert to camatose
Fontanels in dehydration - Answers - mild: soft and flat
- moderate: sunken
- severe: sunken
Eyes in dehydration - Answers - mild: normal
- moderate: mildly sunken orbits
- severe: deeply sunken orbits
Oral mucosa - Answers - mild: pink and moist
- moderate: pale and slightly dry
- severe: dry
skin turgor - Answers - mild: elastic
- moderate: decreased
- severe: tenting
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