types of dehydration

Flowchart nodes

• 135 meq/l

• 145 meq/l

• 150 meq/l

• hyponatremia

• normal value

• hypernatremia

• severe hypernatremia

• Serum Na

• Both of them (hypo-natremia & iso-natremia ) treated by :-(Normal Na -patient Na )X 0.6 X BWT =meq of Na during 24/36 hrs

• Hypernatremia treated by 75 ml/kg/4hrs ORS SLOWLY 1/3 Glucose Saline. Drop S. Na =10-15 meq/l only daily.  

• 5.3

• 3.5

• Serum K+

• Hypokalemia

• Treated of hypokalemia by:- 1-initial Rehydration  2-after urination add K+ 3-late repair hypokalemia   +orally 2.5-3.5meq /kg/day   +IV. fluid Max 40 meq/l/day  -1mlKcl=2meq . 

• Hyperkalemia

• Metabolic acidosis 

• increase HCO3 Kussmulal breathing

• treatment of  metabolic acidosis :- 1-trt dehydration. 2-improve kidney perfusion 3-by 1,2, kidney start to reabsorb the bicarbonate. 4-if NOT! investigate the kidney function. 

• Maintance Fluid Therapy

• FLUID TO MAINTANCE WITHOUT DEHYDRATION UNCONSCIOUS CHILD. unable to drink /eat for several reasonces

• Holiday -Segar Formula For maintance Fluid Requirement

• Child more than 21 kg

• Child 20 kg

•  Child 10 kg 

• 100 kcal /kg=100ml/kg

• 1000 +50 kcal  X kg >10 kg

• 1500 +20kcal/kg  X kg >20Kg

• e.g.25 kg  1500 +(20X5)=1600 

• e.g. 15kg  1000+(50X5)=1250

• Caloric expeniture