Fluids

Question 1

What is the maintenance dose for a child who weighs 35kg (not DKA)

Answer 1

10 x100 = 1l
10 x 50 = 500ml
15x20 = 300ml

=1.8l

Question 2

What is the maintenance dose for a 10kg child(non dka)

Answer 2

1l

Question 3

In DKA what is the fluid bolus rate

Answer 3

10ml/kg

can be given upto twice to recover circulating volume.

Question 4

A child with DKA weighing 25kg is admitted with a pH of 7.14. What is their hourly flow rate of fluids?

Answer 4

Maintenance - over 10kg they recieve 1ml/kg/hr
They are assumed to be 5% dehydrated.

26 plus 20 = 46ml/hr

Question 5

How much maintenance do DKA recieve?

Answer 5

0-10kg = 2ml/kg/hr
10-40kg = 1ml/kg/hr
40+kg = 40ml/hr standard.

Question 6

What concentration of potassium should be given in DKA?

Answer 6

40mmol/l in all fluids (except bolus) until the plasma glucose falls to 14mmol/l

Question 7

When should you start insulin in DKA?

Answer 7

1-2 hrs after reyhdration begins

Question 8

What changes when the plasma glucose reaches 14mmol/l

Answer 8

GLucose should be added to fluids at 5% if ketones less than 3 and at 10% if ketones more than 3.

insulin should be reduced(or maintained) to 0.05units/kg/hr if ketones <3 and should be maintained at 0.1units/kg/hr (or what it was on) if ketones are greater than 3.

Question 9

What is the usual resuscitation bolus?

Answer 9

20ml/kg (10 IN DKA)