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[3] [27] Once the patient is stable, it is important to identify the underlying cause of hypernatremia as that may affect the treatment plan. [3] [27] The final step in treatment is to calculate the patients free water deficit, and to replace it at a steady rate using a combination of oral or IV fluids.
K deficit (in mmol) = (K normal lower limit − K measured) × body weight (kg) × 0.4 Meanwhile, the daily body requirement of potassium is calculated by multiplying 1 mmol to body weight in kilograms. Adding potassium deficit and daily potassium requirement would give the total amount of potassium need to be corrected in mmol.
Isonatremic (normal blood sodium levels) Example: a child with diarrhea, because both water and sodium are lost in diarrhea. Hyponatremic (abnormally low blood sodium levels). Example: a child with diarrhea who has been given tap water to replete diarrheal losses. Overall there is more water than sodium in the body.
Primarily aimed at pediatric patients, the Holliday-Segar formula is the most commonly used estimate of daily caloric requirements. [2] To date, the formula continues to be recommended in the current clinical practice guidelines of the American Academy of Pediatrics , American Society of Parenteral and Enteral Nutrition , and National Health ...
Hopefully, patients will graduate to the medium dehydration or "some" dehydration category and receive continued treatment as above. [1] Inadequate replacement of potassium losses during diarrhea can lead to potassium depletion and hypokalaemia (low serum potassium) especially in children with malnutrition.
The trans-tubular potassium gradient (TTKG) is an index reflecting the conservation of potassium in the cortical collecting ducts (CCD) of the kidneys. It is useful in diagnosing the causes of hyperkalemia or hypokalemia. [1] [2] The TTKG estimates the ratio of potassium in the lumen of the CCD to that in the peritubular capillaries.
In children, compensation can result in an artificially high blood pressure despite hypovolemia (a decrease in blood volume). Children typically are able to compensate (maintain blood pressure despite hypovolemia) for a longer period than adults, but deteriorate rapidly and severely once they are unable to compensate ( decompensate ). [ 14 ]
An arterial blood gas (ABG) test, or arterial blood gas analysis (ABGA) measures the amounts of arterial gases, such as oxygen and carbon dioxide.An ABG test requires that a small volume of blood be drawn from the radial artery with a syringe and a thin needle, [1] but sometimes the femoral artery in the groin or another site is used.