• Types of dehydration: Isotonic, hypotonic, hypertonic (see Ecollege:DocSharing: Powerpoints: GI
dysfunction)
➢ Babies= ECF > ICF (75% water) leads to more rapid loss
➢ Isotonic Dehydration: This is the primary form of dehydration occurring in children (Na remains
normal since H2O loss and electrolyte loss are equal. Leads to shock) H2O loss = electrolyte loss
hypovolemic shock. The major loss is from the ECF. Symptoms are related to hypovolemic shock
,➢ Hypotonic Dehydration: Dehydration occurs when the electrolyte deficit exceeds the water deficit.
Water moves from ECF to ICF which further increases the ECF volume loss and leads to shock.
(Na level usually less than 130 mEq/L) Electrolyte loss >H2O loss shock & seizures (low sodium)
, ➢ Hypertonic Dehydration: Dehydration results from water loss in excess of electrolyte loss and is
usually caused by a proportionately larger loss of water or a larger intake of electrolytes. This type of
dehydration is the most dangerous and requires much more specific fluid of therapy. (Na level usually
greater than 150 mEq/L Causes lethargy, seizures, hyperirritability to stimuli losing fluid from the
ICF) H20 loss > electrolyte loss neuro.
• Nursing care of dehydration: oral & intravenous rehydration, reintroduction of regular diet
The major goals in the management of acute dehydration include 1) assessment of fluid and electrolyte
imbalance, 2) rehydration 3) maintenance fluid therapy, and 4) reintroduction of an adequate diet. Treat
infants and children with acute diarrhea and dehydration first with oral rehydration therapy (ORT). ORT is one
of the major worldwide health care advances. It is more effective, safer, less painful, and less costly than IV
rehydration. Oral rehydration solutions (ORSs) enhance and promote the reabsorption of sodium and water.
These solutions greatly reduce vomiting, volume loss from diarrhea, and the duration of the illness.
Rehydration with oral solutions can be used over 4-6hours of mild to moderate dehydration.
IV rehydration (Normal saline 20ml/kg; lactated ringers 20ml/kg infuse over 20minutes. You need a doctor’s
order to do a bolus) if severe and unable to take by mouth (PO). Reintroduction of regular diet after
rehydration.
• Know the formula for calculating the daily fluid requirements based on kg weight of a child pg.947
➢ 1-10kg = 100ml/kg
➢ 11-20kg = 1000ml + 50ml/kg for each kg > 10kg
➢ > 20kg = 1500ml + 20ml/kg for each kg > 20 kg
Cardiovascular concepts Chapter 34:
• Review VSD, coarctation of the aorta symptoms, expected labs, nursing diagnoses
➢ Ventricular Septal Defect (VSD): is an abnormal opening between the right and left ventricles.
20-60% of VSDs close spontaneously (spontaneous closing is more likely to happen during the first year
of life in children having small or moderate defects).
➢ Signs and symptoms of VSD: murmur, poor feeding and failure to thrive, fast breathing and fatigue &
SOB. It is classified under increased pulmonary blood flow (acyanotic defect).
➢ Diagnostic tests (9th edition table 34-1 <procedures for cardiac diagnosis> pg 1346 is a good table):
Radiologic imaging (chest X-ray), Electrocardiography, Echocardiography, Cardiac catheterization
(most invasive), Cardiac magnetic resonance imaging.
➢ Coarctation of the aorta symptoms (obstructive defect): is a narrowing of the aorta. When this occurs,
your heart must pump harder to force blood through the narrow part of your aorta. Symptoms include:
Pale skin, irritability, heavy sweating, difficulty breathing, murmur, a weak or delayed pulse, high blood
pressure, and difficulty feeding (failure to thrive).
➢ Nursing diagnoses:
o Fluid volume excess related to edema secondary to CHF
o Impaired gas exchange related pulmonary congestion secondary to increased pulmonary blood flow
o Imbalanced nutrition: Less than body requirements related to respiratory distress, feeding difficulties
o Interrupted Family Processes related to presence of a child with a life threatening illness
o Activity intolerance related to respiratory distress, fatigue
o Decreased Cardiac Output related to structural defect, myocardial dysfunction, altered hemodynamics
o Ineffective breathing pattern related to pulmonary congestion, decreased cardiac output
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller GradeProfessor. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.59. You're not tied to anything after your purchase.
