Peds IV fluids

Question 1

holliday-segar method

Answer 1

4-2-1 rule!

• <10 kg- 4 ml/kg/hr
• 10-20 kg- 2 ml/kg/hr
• > 20 kg- 1 ml/kg/hr

Question 2

electrolyte requiremetns

Answer 2

• Na- 3 mEq per 100cc water

- K- 2 mE1 per 100cc water

Question 3

25 kg child- what is hourly IV fluid rate?

Answer 3

-4 x 10= 40
-2 x 10= 20
-1 x 5= 5
65 cc/hr!!!

Question 4

maintenance fluid- maximum

Answer 4

• maximum total fluid per day- 2,400 mL

- maximum fluid rate- 100 mL/hr

Question 5

NS, 1/2 NS, 1/4 NS- Na, Cl

Answer 5

-NS- Na and Cl is 154
-1/2 NS- 77
-1/4 NS- 34
(NS= 0.9% NaCl)

Question 6

dehydration

Answer 6

• older child- 3%, 6%, 9%

- infant- 5%, 10%, 15%

Question 7

best findings to determine if dehydrated

Answer 7

• capillary refill > 2 s
• dry mucous membranes
• absent tears
• abnormal general appearance

Question 8

Rehydration- do what?

Answer 8

• fluid deficit replaced ON TOP OF maintenance fluid

- fluid bolus- isotonic fluid (NS, LR)- 10-20 cc/kg per bolus!!!

Question 9

fluid bolus

Answer 9

• isotonic fluid (NS, LR)

- 10-20 cc/kg per bolus!!Ka

Question 10

gold standard for assessing degree of dehydration?

Answer 10

weight!!

-pre-illness wt - post illness wt

Question 11

calc fluid replacement for 20 kg child and 10% dehydrated

Answer 11

• 20 kg child is 10% dehydrated
• 0.10 x 20 kg= 2 kg
• 2 kg x 1000= 2000 cc of fluid deficit (1 g = 1 cc)
• bolus (20cc/kg)= 400cc of LR- 1600 cc left
• 1/2 deficit over 1st 8 hrs (800 cc)
• 1/2 deficit over last 16 hrs (800 cc)
• maintenance rate= 60 cc/hr