Fluids

Question 1

How much milk does a baby need feeding per day?

How many times a day should they be fed?

Answer 1

150ml/kg

Approx 8 times

Question 2

How much milk does a 4kg baby need per day?

How much at each feed?

Answer 2

4 x 150 = 600ml/day

600/8 = 75ml each feed

Question 3

What’s the difference between glucose and dextrose fluids?

Answer 3

None, they’re the same

Question 4

How can you estimate a child’s weight?

Estimate the weight of a 6 year old child.

Answer 4

(age+4)x2

(6+4)x2
= 20kg

Question 5

What fluid would you usually prescribe children?

Answer 5

0.9% NaCl + 5% glucose (+/- KCl)

Question 6

What’s the formula for calculating how much maintenance fluid to prescribe a child?

Answer 6

4ml/kg/hr for first 10kg
2ml/kg/hr for second 10kg
1ml/kg/hr for each kg after that

Question 7

Calculate maintenance fluid requirement for a day for a 17kg child.

Answer 7

4 x 10 = 40
2 x 7 = 14
Total = 54 ml/hr

In a day: 54 x 24 = 1296ml/day

Question 8

What’s the hourly rate of fluid for a 60kg child?

Answer 8

4x10=40
2x10=20
1x40=40

40+20+40 = 100ml/hr

Question 9

How would you calculate fluid requirements for a dehydrated patient? (when you’re not given a percentage dehydration)

Answer 9

Add an extra 50ml/kg/day to the maintenance dose.

Calculate daily maintenance dose first, then add 50ml/kg

Question 10

What’s the hourly rate needed for a 12kg child who’s dehydrated?

Answer 10

Calculate maintenance first:
4x10=40
2x2=4
44ml/hr
44x24 = 1056ml/day

Add extra:
50x12=600ml/day

Add them together:
1056+600 = 1656ml/day

Calculate hourly:
1656/24 = 69ml/hr

Question 11

How would you calculate fluid requirement in a shocked patient?

Answer 11

Add an extra 100ml/kg/day to the maintenance

Question 12

What’s the hourly rate needed for a 4.35kg child who’s shocked?

Answer 12

Calculate maintenance:

4x4. 35 = 17.4ml/hr
17. 4x24 = 417.6ml/day

Calculate extra needed:
100x4.35=435ml/day

Add together:
417.6 + 435 = 852.6ml/day

Calculate hourly:
852.6/24 = 35.5ml/hr

Question 13

When would you give a fluid bolus?

What would you give as a fluid bolus?

Answer 13

In shocked patients

20ml/kg of 0.9% NaCl

Question 14

There are some exceptions to the usual fluid rules.

What are they? What should these patients be given?

Answer 14

Trauma patients
Neonates

20ml/kg of NaCl

DKA patients
Instead of maintenance fluids calculated the usual way, should be given 20ml/kg of NaCl but over 48 hrs, so basically 10ml/kg/24hr

Question 15

How do you calculate the fluid deficit of a patient?

PS you’ll be given a percentage

Answer 15

Deficit in ml per 24 hrs:

weight x deficit x 10

Question 16

Calculate the fluid deficit of a 15kg child who’s 8% dehydrated?

Answer 16

15 x 8 x 10 = 1200ml per 24

Question 17

A 23kg child is 5% dehydrated. Calculate their total hourly fluid requirement.

Answer 17

First calculate deficit:
weight x deficit x 10
23 x 5 x 10 = 1150ml per 24hr

Then maintenance:
4x10=40
2x10=20
1x3=3
40+20+3 = 63ml/hr
63 x 24 = 1512ml/24hr

Add together:

1150 + 1512 = 2662ml/24 hr

Calculate hourly:

2662/24 = 111ml/hr