|
Professional Conduct
& Attitude
Skills
Knowledge
Health Supervision
Growth
Development
Behavior
Nutrition
Prevention of Illness
Issues Unique to Adolescence
Issues Unique to Newborns
Medical Genetics
Common Illnesses
& Problems
Common Chronic Illnesses/Disabilities
Therapeutics
Fluid & Electrolyte Management
Poisoning
Pediatric Emergencies
Child Abuse
Child Advocacy
Clinical Cases
|
|
Medical Student Curriculum Guide
Knowledge—Fluid & Electrolyte
Management
Rationale
The need for an uninterrupted supply of water, electrolytes and an energy
source are particularly important in infants and young children because of their
high total body water, basal metabolic rate and daily turn-over of water. When a
child is unable to take oral fluids, appropriate intravenous fluids must be
given to prevent dehydration and electrolyte imbalance. When infants and
children experience excessive fluid losses, they become dehydrated. Left
untreated this can lead to an altered level of consciousness, vascular collapse,
renal failure and death. Young infants with gastroenteritis are particularly
vulnerable to dehydration and electrolyte imbalance. This remains a major cause
of infant and child morbidity and mortality worldwide.
Learning Objectives
-
When a pediatric patient requires maintenance fluids, demonstrate
knowledge of the following:
-
Pathophysiology of hypernatremic and hyponatremic dehydration.
-
Daily water and electrolyte requirements.
-
Factors which increase daily fluid requirements.
-
Conditions in which fluid administration may need to be restricted
(Syndrome of inappropriate ADH secretion (SIADH), congestive heart
failure, renal failure).
-
When a pediatric patient requires a fluid deficit replaced,
demonstrate knowledge of the following:
-
Causes of excessive fluid loss leading to dehydration.
-
Clinical complications of electrolyte disturbances, including
hypernatremia, hyponatremia, hyperkalemia, and acidosis.
Effect of pH on serum potassium levels.
-
Electrolyte composition of standard oral and IV solutions.
-
Appropriate laboratory studies and their interpretation.
Competencies
-
Obtain historical information to assess state of hydration.
-
Recognize the physical exam findings of dehydration.
-
Calculate and write IV orders for initial fluid replacement and
maintenance fluids for a patient with dehydration from 1) gastroenteritis,
or 2) diabetic ketoacidosis.
-
Explain the clinical consequences of electrolyte disturbances, including
hypernatremia, hyponatremia, hyperkalemia, and
hypokalemia, and discuss the effect of pH on the serum potassium level.
-
Explain to parents how to use oral rehydration therapy for mild /moderate
dehydration.
|