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Fluid &Electrolyte Balance in Infants & children
1. Identify nursing interventions for the infant & child with dehydration
Isotonic Dehydration- most common type, electrolyte & water deficits are
present in approximately balanced proportions (loss of equal amounts of
water & electrolytes/salt). Because no osmotic force is present to cause a
redistribution of water between the ICF & ECF, the major loss is sustained
from the ECF compartment. This significantly reduces the plasma volume
& thus the circulation blood volume, with the effect on the skin, muscles,
& kidneys. Shock is the greatest threat to life in isotonic dehydration; &
the child with isotonic dehydration displays symptoms characteristics of
hypovolemic shock.
Plasma sodium remains within normal limits, between 130-150 mEq/L
Dry mucous membranes
Hypotonic Dehydration- the electrolyte deficit exceeds the water deficit
(more electrolytes/salt lost than water). Because ICF is more concentrated
than ECF in hypotonic dehydration, water transfers from the ECF to the
ICF to establish osmotic equilibrium. This movement further increases the
ECF volume loss, & shock is a frequent result. The physical signs tend to
be more severe; sweating, fever, tachypnea. Replacing fluid loss with
just water & not sodium (electrolytes). Also called hyponatremic because
the ECF electrolyte loss is Na.
Plasma sodium concentration is are typically less than 130 mEq/L
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