Dehydration_and_Fluids_Flashcards
What is the most accurate measure of dehydration?
The degree of weight loss during the illness.
What percentage of weight loss indicates clinical dehydration?
≥ 5%
What percentage of weight loss indicates shock?
> 10%
What is the mainstay of therapy if clinical dehydration is present?
Oral rehydration solution (75 mL/kg every 4 hours).
When are IV fluids indicated?
For shock, deterioration, or persistent vomiting.
What is the first context in which you give IV fluids?
Fluid Resuscitation.
What is the fluid bolus for fluid resuscitation in children?
0.9% sodium chloride bolus of 20 mL/kg over < 10 minutes.
What is the fluid bolus for fluid resuscitation in term neonates?
10-20 mL/kg.
What should be done if the child is still shocked after the initial bolus?
Repeat the bolus.
What should be done if larger volumes of fluids need to be given?
Transfer the child to HDU/PICU.
How is fluid resuscitation guidance different in DKA?
There is a risk of cerebral oedema.
What is the second context in which you give IV fluids?
Correction of dehydration.
How do you calculate the volume of fluids for correction of dehydration?
Percentage dehydration × weight (kg) × 10.
How long should fluids for correction of dehydration be given?
Over 48 hours.
What is the third context in which you give IV fluids?
Routine Maintenance.
What is the daily fluid requirement for 0-10 kg body weight?
100 ml/kg.
What is the daily fluid requirement for 10-20 kg body weight?
50 ml/kg for each kg from 10-20 kg.
What is the daily fluid requirement for body weight over 20 kg?
20 ml/kg for each kg from 20 kg onwards.
What is the maximum daily fluid intake for males?
Rarely more than 2500 mL per day.
What is the maximum daily fluid intake for females?
Rarely more than 2000 mL per day.
What should be measured when starting IV fluids and at least every 24 hours thereafter?
Electrolytes and glucose.
What is the total daily fluid requirement for a 20kg child with 5% dehydration?
2000 ml over 24 hours (83 ml/hour).
What is the maintenance fluid requirement on Day 1 for neonates?
50-60 ml/kg/day.
What is the maintenance fluid requirement on Day 2 for neonates?
70-80 ml/kg/day.
What is the maintenance fluid requirement on Day 3 for neonates?
80-100 ml/kg/day.
What is the maintenance fluid requirement on Day 4 for neonates?
100-120 ml/kg/day.
What is the maintenance fluid requirement on Day 5-28 for neonates?
120-150 ml/kg/day.
What type of fluids should be used for term neonates?
Isotonic crystalloids with 5-10% dextrose.
What are the symptoms of hypernatraemic dehydration?
Jittery movements, increased muscle tone, hyperreflexia, convulsions, drowsiness, or coma.
What should be used to rehydrate in hypernatraemic dehydration?
Oral rehydration solution.
What is the risk of a rapid reduction in plasma sodium concentration in hypernatraemic dehydration?
Seizures and cerebral oedema.
How should the fluid deficit be replaced in hypernatraemic dehydration?
Over at least 48 hours.
How frequently should plasma sodium be measured in hypernatraemic dehydration?
Regularly.
