Acid Base
Balance
Balance
What are the 4 types of buffers?
Bicarbonate
Proteins
Hemoglobin
Phosphate
A child has be diagnosed with Hyperkalemia, the nurse anticipates she will give what 2 medications to reverse it?
Sub Q Insulin
Oral Glucose
At what stage in CHF can you anticipate seeing a weight loss in the child?
Early Stage
What are some manifestations the nurse will anticipate on their patient with Extracellular Fluid Volume Excess?
Bounding Pulses
JVD
Edema
Dyspnea
Crackles
Which age group is more susceptible to dehydration?
Newborns/Infants
What are some causes of respiratory acidosis?
Croup
Epiglottitis
Aspiration
Cystic Fibrosis
What is a normal range of urine specific gravity?
Well Hydrated <1.010
Minimal dehydration 1.010-1.020
Significant Dehydration 1.021-1.030
Severe Dehydration >1.030
In this stage of CHF you can see JVD, Edema, cyanosis, tachypnea, and wheezes or crackles.
Progressed Stage of CHF
What is an infants body consist of that is highest at birth and decreases with age?
Water
What level of dehydration has the manifestation of delayed capillary refill of >4-5 seconds?
Severe Dehydration
What acid base imbalance can develop with hyperventilation and Salicylate poisoning?
Respiratory Alkalosis
What electrolyte imbalance can develop from inadequate breastfeeding and/or over concentrating formula?
Hypernatremia
What are some diagnostics used to diagnose CHF?
Echo
Chest Xray
CBC, CMP, ABG, BNP
What can cause an Extracellular Fluid Volume Excess?
an imbalance of aldosterone
excess sodium- containing isotonic IV fluid
What are some ways an infant can become dehydrated?
Too high formula concentration
Tachypnea
Diarrhea
Phototherapy
What type of acid base imbalance is seen with Kussmaul Respirations due to and excess accumulation of acid and loss of Bicarb?
Metabolic Acidosis
If a patient has a positive Trousseau and Chvostek sign this is highly indicative of what electrolyte imbalance?
Hypocalcemia
What is an autoimmune connective tissue disorder that can result due to an untreated strep A infection?
Acute Rheumatic Fever
What type of fluid volume excess is defined by a decrease in blood osmotic pressure and an increase in hydrostatic pressure?
Interstitial Fluid Volume Excess
What is recommended for mild to moderate dehydration?
Oral Fluids
IV fluid replacement is only for Severe Dehydration or if the child is unable to tolerate oral fluids.
What is a normal pH range?
PaCO2?
HCO3 (bicarb)
PaCO2 35-45
HCO3 22-26
What electrolyte is responsible for muscle and nerve function, secretion of hormones, bone formation and strength, and blood clotting?
Calcium
What disease process is the leading cause of acquired heart disease in the US and has a risk factor for developing coronary aneurysms in the Sub Acute Phase?
Kawasaki Disease
What manifestations can you see with Interstitial Fluid Volume Excess?
Generalized swelling, pain, restricted ROM, thin and shiny skin
A child's laboratory work comes back showing elevated glucose and elevated sodium levels. All other labs are normal. What type of dehydration does the child most likely have?
Hypertonic Dehydration