Dehydration/ Overhydration test 2

Question 1

What would you assess via heart for if dehydrated? How often should you assess?

Answer 1

o Tachycardia initially or bradycardia occurring late(worse)
 Check every 15 minutes

Question 2

What is the rule for potassium if hypokalemic?

Answer 2

void first before giving potassium

Question 3

What are the rules for IV replacement therapy INITIALLY?

Answer 3

 10-20 ml/kg/bolus for quick expansion of ECF

 You can only give 3 boluses back to back

Question 4

How do you calculate IV fluids?

Answer 4

o 4-2-1 rule
 Use the first 10 kg of the weight and multiply by 4
 Use another 10 kg of the weight and multiply by 2
 Use the remaining kg of the weight if need and multiply by 1
 Add together to get the pump setting
• Calculating IV Fluids: 4-2-1 Rule Max allowed: 2,400/day
• Ex: 60kg 10x4= 40 10x2=20 40x 1= 40 =100ml/hr
•
• 1st: 10kg x 4
• 2nd: 10kg x 2
• 3rd: 1ml/kg/hr

Question 5

How can FLuid overload occur?

Answer 5

o May happen if too much IV bolus is used or too much fluid replacement is used
 Make sure to check the maintenance running
 Feeding incorrectly causes giving too much water
 Too fast in reducing glucose for someone going through DKA
 Ingesting water while swimming

Question 6

What are the S/S for fluid overload?

Answer 6

	Weight gain
•	When obtaining weight, measure your own weight measure and do not take the parent’s word for it
	Bounding pulse
	Jugular vein distention may occur but NOT IN INFANTS
	Edema
	Respiratory distress
•	Dyspnea
•	Crackles

Question 7

What are teh treatments for fluid overload?

Answer 7

• Stop IV fluids
• Take diuretics
• Obtain labs such as BMP (basic metabolic panel)
o Helps assess hyponatremia