12: Pediatric IV Fluids & Med Dosing Flashcards
general rule of how much water pts lose for every 100kcal/kg of energy expended
100mL
daily caloric expenditure for health children who weigh: <10kg, 10-20kg, 20-80kg, and 80+ kg
- <10kg: 100 kcal per kg
- 10-20kg: 1000 kcal + 50kcal per kg above 10
- 20-80: 1500 kcal + 20kcal per kg above 20
- 80+kg: 2700 with adjustments as needed
insensible water loss
loss not perceived by the individual and cant be measured (skin loss, respiratory loss)
sensible water loss
losses that can be seen/measured (urine, stool, visible sweat)
what proportion of kcal of energy expenditure does sensible vs insensible water loss make up?
sensible is 55%, insensible is 45%
two possible fluids to choose for a pediatric rehydration bolus
LR (lactated ringers) or NS - always an isotonic fluid
what can happen if you rehydrate a pt with 1/2 or 1/4 NS? **
hyponatremia risk
what do you have to do before giving K in a rehydration solution
make sure kidneys are functioning
NS has ___ mEq of NaCl per Liter**
154 mEq
NS is ___% NaCl**
0.9%
four PE findings that are basically diagnostic of dehydration in kids
- cap refil >2 sec
- dry mucous membranes
- absent tears
- abnormal general appearance
what is 1st line therapy: IV or oral rehydration and why
oral - IVs come with minor risks that drinking does not
rehydration drink recommended for all ages vs recommended for 2yrs+
pedialyte for all ages, gatorade for 2+ yrs
four factors as to why there is no “standard dose” for pediatric meds
- absorption varies
- distribution into tissues varies
- metabolism varies
- elimination varies
two formats for pediatric dosing
mg/kg/day or mg/kg/dose
