Fluid Balance and Third-Spacing

By the end of this lesson you will be able to: - Name the body fluid compartments and explain which forces move water and sodium between them, including why the revised Starling model changes how we think about edema and fluid resuscitation. - Distinguish a volume problem (deficit, excess, or a shift into a third space) from a concentration problem (sodium and osmolality), and explain why the two are assessed and treated differently. - Perform and interpret intake and output (I&O), daily weights, urine output per kilogram per hour, and orthostatic vital signs, and combine them with examination findings instead of relying on any single number. - Calculate, with the arithmetic shown and checked: net fluid balance, weight change converted to fluid change, an IV rate in mL/h, a drip rate in gtt/min, hourly pediatric maintenance (4-2-1), and an initial weight-based resuscitation volume. - Compare 0.9% sodium chloride, balanced crystalloids, hypotonic fluids and colloids, and name the risks that make a hypotonic maintenance fluid hazardous in hospitalized children. - Recognize the red flags of shock, pulmonary edema and symptomatic hyponatremia,...