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Fluid and electrolyte imbalance

Fluid and electrolyte imbalance. Emad Al Khatib , RN,MSN,CNS 1-11-2010. Distribution of body fluid. *TBW *ICF *ECF ( intravascular, interstitial &trancelluler) Fluid % in child body ( 75%-80%) *keep balance of water & electro ( Bwt, age ,activity level ,&body temp).

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Fluid and electrolyte imbalance

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  1. Fluid and electrolyte imbalance Emad Al Khatib, RN,MSN,CNS 1-11-2010

  2. Distribution of body fluid *TBW *ICF *ECF ( intravascular, interstitial &trancelluler) Fluid % in child body ( 75%-80%) *keep balance of water & electro ( Bwt, age ,activity level ,&body temp)

  3. Pediatric Fluid Therapy Principles Maintenance H2O needs: Weight in Kg H2O fluid needs 1-10 100cc /kg /day 11-20 1000+50cc/kg/day > 20 1500 + 20cc/kg/day Add 12 % for every 0C

  4. Na+ & K+ Daily Needs • Na+ = 3 meq / kg / day • K+ = 2 meq / kg / day • Notice: • Daily fluid maintenance in pediatrics: • 0.18% saline ( 30 meq Na+ ) + 2 meqkcl / 100 cc.

  5. Nursing requirements of FLUID Increased requirement : • Fever • Vomiting • Renal failure • Burn • Shock • Tachypnea • Gastroenteritis • Diabetes (Insipidus, mellitus - DKA)

  6. Decreased requirement • CHF • oliguric( RF ) • Increase ICP

  7. Physical Signsof Dehydration

  8. Correction of Dehydration • Moderate to severe dehydration: IV push 10-20 cc / Kg Normal saline (5 % albumin). • Half deficit over 8 hours, and half over 16hours.

  9. Nursing Intervention 1. Assessment 2. History 3. Clinical observation 4. Intake & output measurement 5. Replace orally or IVF ( 1g wet diaper wt =1 ml urine )

  10. Disturbance of F&E balance 1. Na 2. K 3. Ca ( Na is the primary osmatic farce ) Serum Osmolality Defined as the number of particles per liter. May be approximated by: 2(Na) + Glucose (mg/dl)/18 + BUN(mg/dl)/2.8 Normal range: 275-295 mOsm/L.

  11. Type of Crystalloid Fluids 1. Isotonic 2. Hypotonic 3. Hypertonic

  12. Types of I.V solutions Solutions are three types -Isotonic it's total osmolality (TO) = TO of blood - Hypotonic: It's TO  TO of blood • Hypertonic: it's TO  TO of blood. * Electrolyte solutions considered isotonic If total electrolyte content (TEC)  310mEq/L. and hypotonic if TEC  250 meq/L and hypertonic if TEC  375 Meq/L

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