NURSING 202 Medsurg /Nursing Care for the Child who is Experiencing Dehydration

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• Pediatric Differences • Infants: • Higher % of water in ECF; infants can lose fluids = to their ECF within 2 to 3 days. • Less able to concentrate urine b/c of immature renal function.... • Higher rate of peristalsis than other children. • Immature lower esophageal sphincter, making them more prone to gastroesophageal reflux, which can lead to dehydration and electrolyte disturbances. • Harder time compensating for acidosis b/c of their decreased ability to acidify urine. • Infants + Young Children: • Higher metabolic turnover of water relative to adults because of a higher metabolic rate. (If losses are not replaced rapidly, imbalance occurs.) • Faster respiratory rate results in higher evaporative water losses. • Unable to verbalize/communicate thirst. • Infants + Children: • Compared to adults, infants and children have a proportionately greater body surface area in relation to body mass, resulting in a greater potential for fluid loss through the skin and GI tract. • Higher proportionate water content • Premature Infants – 90% • Term Infants – 75% to 80% • Preschool Children – 60% to 65% • Adolescents/Adults – 55% to 60% • Because of the child’s ability to compensate and maintain an adequate cardiac output, changes in heart rate, sensorium, and skin color are earlier indicators of impending shock than is blood pressure. (SAFETY ALERT!!) • Extracellular Fluid Volume • Neonate: Approximately 40% body water is located in the ECF compared w/ 20% in adolescent/adult. • Approximately 50% of ECF is exchanged daily in an infant – this is why dehydration can occur very suddenly and rapidly if fluid intake is inadequate or fluid losses are excessive. • Depletion of ECF, often caused by gastroenteritis, is one of the most common problems among infants and young children. • Primary electrolyte of the ECF is sodium. [Show More]

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