Prerequisites

1.  Water and electrolyte distribution in body compartments

2.  Change in total body water with age: newborn, less than 2 years of age, greater than 2 year of age

3.  Relationship between basal metabolic rate and daily water requirements

4.  Daily glucose requirements to prevent ketosis

5.  Role of the adrenal gland and antidiuretic hormone (ADH) in maintaining serum sodium, glucose, and body water

6.  An understanding of renal function and the ability to distinguish between renal and pre-renal azotemia

Learning Objectives

Activities

K.1

Obtain historical information to assess state of hydration

Lecture on Fluids and Electrolytes

K.2

Recognize the physical exam findings of dehydration, including differences between types

K.3

Demonstrate knowledge of the following for a pediatric patient requiring maintenance fluids:

!                   daily water and electrolyte requirements

!                   factors which increase daily fluid requirements

!                   pathophysiology of hypernatremic and hyponatremic dehydration

!                   conditions in which fluid administration may need to be restricted

K.4

Demonstrate knowledge of the following for a pediatric patient requiring deficit replacement:

!                   causes of excessive fluid loss leading to dehydration

!                   clinical complication 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 interpretations

Learning Objectives

Activities

K.5

Explain when it is appropriate to use and how to use oral rehydration therapy

K.6

Calculate and write IV orders for initial fluid replacement and maintenance fluids for a patient with dehydration from gastroenteritis or diabetic ketoacidosis.