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