dehydration

[3kidsmom]

Hello,

I am a first year nursing student in a 2 year ADN program. My pediatric clinical instructor wanted us to look up the three different types of dehydration (isotonic, hypotonic, and hypertonic) which I did but I am confused on how you would know what IV solution you should give them to get them hydrated. I know .9NS is an isotonic solution but after that I kind of lose it. I hope this isn't confusing..any help would be appreciated.

Kate

[Daytonite, BSN, RN]

hi, kate!

http://www.nursewise.com/courses/iv_hour.htm - this article on iv therapy includes a table of the most commonly used iv solutions and how they are commonly used. there really are only a couple of iv fluids used for fluid replacement: normal saline (0.9% nacl), d5 w/normal saline, and d5 w./1/2 normal saline. you have to watch what is going on with the sodium and chloride ions when you are replacing body fluids.

this link http://www.fpnotebook.com/ped9.htm will take you to an outline in the family practice notebook on pediatric dehyration. be sure to click on the link at the bottom of the page "pediatric dehydration management". one of the things i noted is that they list lactated ringers as one of the iv fluid choices to give a pediatric patient. just so you are aware, this is a physician website, but it never hurts to know what a physician is likely to order.

http://search.nlm.nih.gov/medlineplus/query?disambiguation=true&function=search&server2=server2&server1=server1&parameter=dehydration - this is a page of links to lots of information on dehydration from the medline plus site. some of the links have some nicely presented lists of signs and symptoms of dehydration in simply written language (these are designed for the general public). the lists of links are not complete and can be expanded so you will find even more links to check out.

http://www.merck.com/mrkshared/cvmhighlight?file=/mrkshared/mmanual/section19/chapter259/259b.jsp%3fregion%3dmerckcom&word=dehydration&domain=www.merck.com#hl_anchor = another link of information i found this evening

there is a lot of information about dehydration in kids in the medline plus links. i was an iv therapist for many years. in general, unless a child is very, very dehydrated, you would want to try to hydrate them orally if you can. keeping an iv in a kid is a logistical problem as the younger ones want to pull it out the minute they can get their little fingers into it. they need to be restrained physically to put the iv in and there is a lot of screaming and crying on their part. they often need to be restrained once the iv is in so they don't pull it out. now, i'm talking about the kids up to 2 and 3 years old. the 4 and 5 year olds are more cooperative. i suspect that your instructor is going to want you to know how a young kid gets dehydrated that badly, so you want to check out those medline plus links.

[3kidsmom]

Thank you Daytonite for all the helpful information!

I appreciate it....

Kate