00:01
Hi, I'm Amy.
00:02
I am a pediatric nurse
practitioner.
00:05
And we are going
to be talking about
fluid balance in
pediatric patients today.
00:12
So, why do we even
need to talk about fluid?
It turns out the fluid
is really important
for pretty much
everything in your body.
00:20
So, on this slide,
we're going to talk about
some of the different things
that we need fluid for.
00:26
This first picture shows that
it we need it for transport.
00:30
So, anything that needs to be
transported from one place
to another place
in your body,
it's really going to need fluid
to be able to help you get there.
00:39
On this second tile here,
you will see that
temperature regulation
is also really important.
00:45
We sweat.
00:46
When we're exercising, we sweat.
00:48
When we're nervous, we sweat.
00:50
And that takes fluid.
00:52
So, we're going to
lose fluid that way,
and we need to replace it.
00:55
So, fluid is really important
for temperature regulation.
00:59
Additionally, there's some more
chemistry related things
that fluid do.
01:05
Like, it cuts sucrose, so that we
can use it for energy in the body.
01:08
That's not quite as
important for your nursing practice
but it's just kind of an
interestingfact to know.
01:15
So, where is all of this fluid
that we take in?
And how do we kind of
think about the fluid
as we're going through
our daily nursing tasks?
It turns out that there's a
couple of big buckets of fluid.
01:30
This first bucket is Intracellular.
01:33
The term intracellular just
means that's fluid inside the cells.
01:38
Every single little cell
that's in your body
is going to have
some fluid in it.
01:42
And the water that is in your body,
the total body water,
that is inside these cells,
that's about 2/3
of all of the water
that's in your body.
01:52
So, that's the first big bucket.
01:54
That's what you see here.
01:56
Now, the second bucket
is the other 1/3 of the water
that's in your body.
02:03
And that's going to be
Extracellular.
02:05
So, it makes sense.
Right?
There's fluid inside your cells.
02:08
There's fluid outside your cells.
02:10
So, the extracellular fluid is the
fluid that's outside of your cells.
02:14
Again, that makes up about
a third of your total body water.
02:18
And there's a couple of
smaller buckets
inside that extracellular fluid.
02:23
One of those is plasma.
02:26
The other one is
interstitial fluids.
02:28
So, as you're thinking about
the fluid that is
rolling around in your body.
02:32
It's really those two big buckets
inside the cells, outside the cells.
02:37
And then, the fluid that's
outside of your cells
is located in a couple of places
that we're going to talk about.
02:45
This slide is really just
a representation
kind of to help you think about
where that fluid is located.
02:52
You'll see that the pictures
on the top represent the cells.
02:57
And then, there is a blood
vessel right underneath that.
03:01
And that represents where the fluid
is kind of rolling through your body
and transporting all of those
things that we talked about.
03:09
So, again, intracellular fluid.
03:12
Those cells make up a lot
of the volume
of the total body
water that is there.
03:19
And then, the extracellular fluid
in that rolling around
through those blood vessels and
in a few other places in your body
is represented here.
03:30
So that extracellular fluid
we talked about.
03:33
There's a couple of other buckets.
They're smaller.
03:35
One of those is plasma.
03:37
So that's rolling through
that blood vessel right there.
03:39
The other one is interstitial fluid.
03:42
There is fluid in and
around the cells.
03:47
And there's a couple of
different places
that we really see that fluid.
03:51
Examples of this are
your cerebral spinal fluid,
your pleural fluid,
so that's fluid
that's located in your lungs.
03:58
Your pericardial fluid,
that's fluid that's in that sac that
your heart kind of floats in,
and your peritoneal fluid,
so that fluid
that is in the abdominal space.
04:11
It also turns out that
there's differences in
the amount of body water
that you have,
that are associated with your age.
04:20
And this is why understanding
fluid in pediatrics is so important,
because it turns out that
infants and newborns
are about 80% total body water.
04:32
Whereas you can see, as you age,
that percentage of total body water
starts to decrease over time.
04:39
Why is this important for you?
Well, this is important because
infants and children,
we really have to stay on top
of their fluid status.
04:49
They become dehydrated
much more quickly.
04:52
And it really is important
to note that even though
an infant might have
an IV fluid rate for example,
that is fairly low,
it is still percentage wise,
a very important part of their care.
05:06
And it is really important
to make sure
that they don't get dehydrated.
05:11
So this graph,
I don't want you to be
overwhelmed by this graph.
05:16
It's just a way for you to look at
and kind of visualize the fact
that there's differences in
your total body water by age.
05:24
So you'll notice that a
premature infant,
their body water is located
in slightly different areas
than the adult on the other side of
the chart.
05:34
The premature infant has a
really high percentage
of total body water.
05:39
And then, you will see that
the adult, it is much lower.
05:44
And again, you don't have
to memorize this graph.