Fluid prescribing

Question 1

Daily requirements of water

Answer 1

25-30ml/kg/24h

Question 2

Daily electrolyte requirements

Answer 2

1mmol/kg/24h Na and K (and Cl)

Question 3

Daily glucose requirements

Answer 3

50-100g/24h glucose

Question 4

Maximum K+ replacement rate

Answer 4

10mmol/h

Question 5

Emergency resuscitation

Answer 5

sodium chloride 0.9% 500ml 15m

Question 6

Emergency hypogylcaemia

Answer 6

glucose 20% 100ml 15m

Question 7

Emergency hypokalaemia

Answer 7

sodium chloride 0.9% / potassium chloride 0.3% 1000ml 4h

Question 8

Emergency Hypercalcaemia

Answer 8

sodium chloride 0.9% 1000ml 4h

Question 9

Maintenance fluid with losses e.g. Vom/diarrhoea

Answer 9

minimum 30ml/kg/24h water
ensure electrolytes replaced

(aim 1000ml 4-6h)

Question 10

Emergency resuscitation child

Answer 10

sodium chloride 0.9% 20ml/kg 15m

Question 11

Maintenance for child

Answer 11

100ml/kg/24h for <10kg
50ml/kg/24h for 10-20kg
20ml/kg/24h for >20kg

Question 12

Maintenance only

Answer 12

sodium chloride 0.9% / potassium chloride 0.3%, 1000ml over 8-12h

Question 13

Maintenance only but previous bag given

Answer 13

glucose 5% / potassium chloride 0.15%, 1000ml over 8-12h (12h)
As glucose was not given already
and potassium is still required

Question 14

patient with gastroenteritis Na 137 (137-144), K 3.4 (3.5-5.3), U 7.0 (2.5-7.0), Cr 100 (60-110)
What would you give

Answer 14

Maintenance and replacement
sodium chloride 0.9% / potassium chloride 0.3%, 1000ml over 4-6h