Pediatric Fluid Balance (Nursing)

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.