Question

1. Describe insensible fluid loss, obligatory fluid loss, and abnormal fluid loss
2. Provide 3 reasons infants are at greater risk for dehydration
3. Provide 3 causes of constipation in the pediatric patient
4. Provide 6 risk factors for a urinary tract infection in the pediatric patient
5. Compare the pathophysiology of nephrotic syndrome and glomerulonephritis

Answer 1

1) Fluid is lost from the body through sensible and insensible losses.

- Sensible losses can be measured and include fluid lost during urination, defecation and wounds.

- Insensible losses cannot be measured or seen and include fluid lost from evaporation through the skin and as water vapour from the lungs during respiration.

The minimal amount of fluid lost from the body that can occur is referred as the obligatory fluid loss. It includes loss of fluids through urine, stool, breathing and sweating.

Components of daily obligatory fluid loss:-

- Insensible loss :- 800 mls

- Minimal Sweat loss :- 100 mls

- Faecal loss :- 200 mls

- Minimal urine volume to excrete solute load :- 500 mls

- Total :- 1600 mls

Abnormal fluid loss from the body is due to vomiting, diarrhoea, severe perspiration, severe burns, gastric suction, bleeding and diuretic drugs. This result in extreme thirst and dehydration.

2) Infant's are at greater risk of dehydration because of following reasons. These are :-

a) Infants have a limited ability to retain the extra fluids need to avoid dehydration and most infants sweat at a much greater rate than adults.

b) Infants metabolism is high as they use more water and yet their kidneys are not quite advanced enough to retain and consverse water needed to avoid dehydration.

c) Diarrhoea and vomiting are the most common causes of dehydration in infants because during an episode of diarrhoea and vomiting infants loses water and electrolytes quickly.

3) Constipation in pediatric patient is a common problem. A constipated pediatric patient has infrequent bowel movements or hard, dry stools.

Causes are as follow:-

a) Withholding :- Child maymay ignore the urge or have a bowel movement because he or she is afraid of toilet or doesn't want to take a break from play.

b) Change in diet :- When the children is not taking enough fiber rich fruits and vegetables or fluids in diet may cause Constipation.

c) Cow milk's allergy :- An allergy to cow milk or consuming too many diary products sometimes can cause constipation.

d) Medications :- Certain antidepressants and various drugs can contribute to cause constipation.