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Fluid and Electrolytes - Coggle Diagram
Fluid and Electrolytes
Physiology
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Causes of Dehydration
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- Inceased losses
Fever
Diarrhoea
Tachypnoea
- Loss of normal fluid retaining mechanisms - burns
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Admin
Oral
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Cochrane systematic review, for every 25 children treated with ORT for dehydration, one faus and requires IV
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IV
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Ni PO requirements not met by intake, increase requirements, increased
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Signs of Dehydration
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- Cool, mottled extremities
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Monitoring on IV
- Measure actual weight asap
- Record daily weights and difference
- Measure input and output with 12 hourly total balances calculated
- Assess ongoing need for IV fluids regularly
- Check plasma electrolytes and blood glucose at start and every 24h
Hyponatraemia
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Common Causes
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- Anti diuretics - desmopressin for noctural enuresis
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Management
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- Check other electrolytes, urinary Na+ and osmolarity
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Hypernatraemia
Causes
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Insensible losses - burns, fever
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Intravascular volume relatively preserved so assessment of
dehydration may be inaccurate and shock occurs late
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Management
- Investigations as per hyponatramia
- Shock - volume resus with 20ml/kg 0.9 Nacl
- Aim to lower serum Na+ slowly at rate of no more than 10mmol/L in 24hrs
Any more rapid can lead to cerebral oedema, convulsions and permanent brain injury
- Replace deficit and maintenance uniformly over 48hrs after resus
- Regular monitoring of electrolytes, weight, neuro status
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Types of Fluid Therapy
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Urine , faeces
Respiration, persperation
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