List some reasons why an infant is more at risk of dehydration compared to an
older child. - ANSWERS-1. An infant has a larger portion of extracellular fluid in
their body.
2. They cannot say the they are thirsty
3. They have immature kidneys, so they pee a lot more
4. They have a higher metabolic rate, which uses up more fluid (Shown in HR)
5. Infants have a higher body surface area and are unable to sweat effectively
6. They put everything in their mouth, which can lead to infection, which can lead
to diarrhea, WHICH CAN LEAD TO dehydration
7. They are susceptible to Rotavirus, which causes diarrhea. There is a high
incidence in developing countries. Vaxx at 2 4 6 months.
8. During infancy there is a high daily fluid requirement with little volume reserve,
this makes the infant vulnerable to dehydration
9. They have a higher RR, and lose water from their respirations
10. They have a greater BSA (3x an adults) so they lose more water through
sweating
11. Immature gastrointestinal system
12. Higher incidence of gastroenteritis
How do we calculate a bolus in pediatrics? - ANSWERS-No heart conditions: 20
mL/kg
Heart conditions, renal issues, on dialysis, etc.: 10 mL/kg
,Usually give NS or LR
Over how long should we give a bolus to a child if stable? How about if unstable? -
ANSWERS-20 minutes.
As fast as humanely possible
How do we calculate maintenance fluids in pediatrics? - ANSWERS-1st 10 kg: # of
kg x 100 mL +
2nd 10 kg (11-20): # of kg x 50 mL +
Left over kg (21+): # of kg x 20 mL
Divide by 24 to get hourly rate
How do we calculate the normal UO of an infant? - ANSWERS-2 mL/kg/hr
How do we calculate the normal UO of a child >1 year old? - ANSWERS-1
mL/kg/hr
How do we calculate the normal UO of a child >30kg? - ANSWERS-No calculation,
just should be 30 mL/hr or more
,List some manifestations you would see in a pediatric patient with dehydration. -
ANSWERS--*Increased HR (Earliest sign)*
Piaget created a theory of development related to what? - ANSWERS-Cognitive
abilities varying from age to age
Erikson created a theory of development related to what? - ANSWERS-
Psychosocial development
Birth to 12 months. Learns trust as basic needs are met. Mistrust if needs not met
or unable to delay gratification. - ANSWERS-Trust vs. Mistrust
12 months to three years. Learns independent behaviors such as feeding and
dressing, exercises choices, exerts self. Shame and doubt if independence is not
encouraged. - ANSWERS-Autonomy vs. Shame and Doubt
, 3-5 years old. Goal direction, competitive, exploratory behavior. Imaginative play.
Initiative occurs when child independently begins inactivity instead of merely
responding to or imitating other. Guilt occurs when caregivers frequently
reprimand behaviors reflecting initiative. - ANSWERS-Initiative vs. Guilt
6-12 years old. Learns self worth. Gains mastery of psychosocial, physiological,
and cognitive skills. Becomes socially and peer focused. Less family focused.
Inferiority can develop when school-age children are ridiculed by peers, don't
measure up to adult standards, or lack certain skills. - ANSWERS-Industry vs.
Inferiority
12-17 years old. Develops a sense of who they are intellectually, cognitively,
behaviorally, and emotionally. Emerging physical and sexual maturity is integrated
with already existing skills and abilities. Gains independence from parents. Peers
are very important. A crucial stage in development, as identity formation affects
commitments and decisions made later in life. Role confusion occurs when the
adolescent is unable to acquire a sense of direction, self, or place within the
world. - ANSWERS-Role Identity vs. Role Confusion
Birth to 2 years. Develops object permanence. Puts things in mouth, learns motor
and vision skills, emphasis on reflexes and reacting to stimuli. Infants try to make
sense of their world through sensory perceptions and and motor activities such as
looking, sucking, rooting, and grasping.
Interested in novelty, repetition; understands causality; solicits help from others
Simple problem solving; imitates
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