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Pediatric Dehydration Assessment Guide

The document describes three levels of dehydration - mild, moderate, and severe. Mild dehydration involves less than 5% fluid loss in infants or 3% in older children/adults, with normal pulse and physical findings but decreased urine output and thirst. Moderate dehydration involves 5-10% fluid loss in infants or 3-6% in older children/adults, along with tachycardia, little urine output, and lethargy/irritability. Severe dehydration involves over 10% fluid loss in infants or 6% in older children/adults and shows rapid, weak pulses and decreased blood pressure, among other concerning symptoms. The document also outlines approaches to re

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Ericka Lyn Arenas Monzon
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915 views5 pages

Pediatric Dehydration Assessment Guide

The document describes three levels of dehydration - mild, moderate, and severe. Mild dehydration involves less than 5% fluid loss in infants or 3% in older children/adults, with normal pulse and physical findings but decreased urine output and thirst. Moderate dehydration involves 5-10% fluid loss in infants or 3-6% in older children/adults, along with tachycardia, little urine output, and lethargy/irritability. Severe dehydration involves over 10% fluid loss in infants or 6% in older children/adults and shows rapid, weak pulses and decreased blood pressure, among other concerning symptoms. The document also outlines approaches to re

Uploaded by

Ericka Lyn Arenas Monzon
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Clinical Evaluation of Dehydration

• Mild dehydration
– (<5% in infant; <3% older child/adult)
– Normal or increased pulse
– Decreased urine output; thirsty; normal physical
findings

Nelson Textbook of Pediatrics , 18th Edition


Clinical Evaluation of Dehydration
• Moderate dehydration
– 5-10% infant; 3-6% older child/adult
– Tachycardia
– Little or no urine output;
– Irritable/lethargic
– Sunken eyes and fontanel
– Decreased tears
– Dry mucus membranes
– Mild delay in elasticity (skin turgor)
– Delayed capillary refill (>1.5 sec)
– Cool and pale
Nelson Textbook of Pediatrics , 18th Edition
Clinical Evaluation of Dehydration
• Severe Dehydration
– >10% in infant; >6%in older child/adult
– Rapid and weak or absent peripheral pulses
– Decreased blood pressure
– No urine output
– Very sunken eyes and fontanel
– No tears
– Parched mucous membranes
– Delayed elasticity (poor skin turgor)
– Very delayed capillary refill (>3 sec)
– Cold and mottled
– Limp & depressed consciousness
Nelson Textbook of Pediatrics , 18th Edition
Approach to Dehydration
• Restore intravascular volume
– Normal saline 20 mL/kg over 20 min
• Rapid volume repletion
– 20 mL/kg Normal saline or ringer lactate over 2 hour
• Calculate 24–hour fluid needs
• Subtract isotonic fluid already administered from
24 hr fluid needs
• Administer remaining volume over 24 hr using D5
½ normal saline + 20 mEq/L KCl
• Replace ongoing losses as they occur
Nelson Textbook of Pediatrics , 18th Edition
Monitoring Therapy
• Vital signs
– Pulse and blood pressure
• Intake and output
– Fluid balance
– Urine output and sp. Gravity
• Physical exam
– Weight and clinical signs of depletion or overload
• Electrolytes
Nelson Textbook of Pediatrics , 18th Edition

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