Dehydration and Fluid Loss (Nursing)

00:01 So now we're going to talk about Dehydration and Loss of Fluid.

00:05 Now that we are pretty sure we know where the fluid belongs.

00:09 So, what does a nurse need to recognize that can cause dehydration in children? Fluid and electrolytes are a great topic to practice these clinical judgment model that you're going to use on your NCLEX.

00:26 We all love the NCLEX. Right? So do you remember the first steps of the clinical judgment model? We're going to recognize those cues that we need to analyze the cues and prioritize a hypothesis.

00:37 Kind of figure out what we're going to do about this, right? So, I want you to think about this presentation in terms of tracking those cues of dehydration, and what you should be looking out for when you're taking care of pediatric patients.

00:51 So at the end, maybe we can see how many you remember from this portion of the series.

00:57 So do you have the answer to your question? We're going to talk about those reasons for dehydration.

01:06 So common causes of fluid loss in pediatrics, there's four really big causes that are pretty clinically relevant.

01:14 The first one is vomiting.

01:15 You know, if you've ever seen a kid vomiting, you know that you can lose a lot of volume through vomiting.

01:23 The second one is diarrhea, same.

01:27 You can lose just a ton of volume if you have a lot of diarrhea going on.

01:32 So the third one are respiratory conditions, and that one might not make as much sense as you know, vomiting and diarrhea.

01:40 When you think of vomiting and diarrhea, we know there's stuff coming out, you know, really out of both ends.

01:45 But when you think about respiratory conditions, if you remember in an earlier presentation, we talked about the fact that when you breathe fast, you lose more fluid.

01:55 And if you've got a cold or pneumonia or something like that going on in your lungs, children really upped their respiratory rate.

02:04 So they're losing a lot more fluid when they have these respiratory conditions.

02:08 And also, they've got all this mucus that's coming out and snot flowing everywhere.

02:14 So all of this extra stuff that's coming out results in a way for pediatric patients to become dehydrated.

02:23 The last big one is fever.

02:26 When your body heats up, it's just like when you are heating a pot of water on the stove.

02:31 That water is going to evaporate off when it gets to those higher temperatures.

02:37 So anytime you've got a pediatric patient, any patient really, but specifically in pediatric patients that have fevers, for long periods of time, high fevers, just remember they're burning off that fluid in their bodies.

02:53 We talked about four main causes of dehydration in pediatric patients.

03:00 And those are really the biggest clinically relevant reasons that patients will lose fluid.

03:05 But there are some other causes of dehydration.

03:08 So just know that if you've got a patient that is excessively sweating.

03:14 So while fever can cause sweating, but also if they're running around in a hot climate, especially if they're not used to that climate, not drinking fluids, exercising, or if they have a clinical condition that causes extra sweating, think cystic fibrosis, that can cause a lot of extra fluid loss.

03:36 You can also have fluid loss in the hospital.

03:41 If you have a surgical patients.

03:43 so maybe they have a drain, maybe they had a surgery on their abdomen, and they're draining a lot of fluid out.

03:48 So that can be a really large piece of losing fluid for that patient and you have to make sure they don't become dehydrated.

03:57 If you have a patient that has burns, for example, then that is a way that they are going to lose a lot of extra fluid.

04:06 They can have all kinds of different to stomach upsets that cause that vomiting and diarrhea, which we already kind of talked about.

04:15 They can also have conditions that cause them to have more urine production.

04:22 So that's known as polyuria, meaning that they are just peeing way more than you would expect them to in a normal situation.

04:30 So patients that have diabetes, especially those patients that are going into a condition called diabetic ketoacidosis or DKA.

04:39 Will be having a lot of losses through their urines.

04:43 The other big reason to have fluid volume deficit is that you can't take enough fluid in.

04:50 So if you don't have access to fluid, if you don't have access to water, you're going to become dehydrated and that just makes sense.

04:58 But sometimes we don't think about those kinds of causes.

05:01 Since maybe you don't have access to great drinking water, and that can cause you to become dehydrated, you also might not be able to physically drink.

05:16 If you think about those conditions that cause severe sore throats, or stomatitis, that can mean that you'll have pediatric patients that will refuse to drink anything because their throat hurts so badly.

05:31 So you would not be able to get enough fluid in if that happens.