Fluids and feeds

Question 1

What are the fluid requirements for:
a) infants
b) toddlers

Answer 1

a) 150ml/kg/day
b) 100ml/kg/day

Question 2

What are the signs of the following levels of dehydration?
a) mild (<5%)
b) moderate (5-10%)
c) severe (>10%)

Answer 2

a) thirst, dry lips, restlessness, irritability
b) sunken eyes, reduced skin turgor, decreased urine output
c) reduced consciousness, cold and mottled peripheries, anuria

Question 3

What are the NICE fluid guidelines for:
a) a dehydrated child?
b) a shocked child

Answer 3

a) maintenance fluids + deficit of 50ml/kg extra over 24h
b) maintenance + deficit of 100ml/kg extra over 24h + fluid bolus

Question 4

What is the fluid given to neonates and what/when electrolytes are included?

Answer 4

10% glucose (higher respiratory and metabolic rate)

Electrolytes are added from day 2:
Sodium 3mmol/kg/day
Potassium 2mmol/kg/day
Calcium 1mmol/kg/day (given rarely)

Question 5

What is the fluid rate for a neonate on:
a) day 1?
b) day 2?
c) day 3?
d) day 4 onwards?

Answer 5

a) 60ml/kg/day
b) 90ml/kg/day
c) 120ml/kg/day
d) 150ml/kg/day

Question 6

What is the formula to estimate a child’s weight?

Answer 6

2 x (age + 4) = weight in kg

Question 7

What is the fluid given to children >1y?

Answer 7

0/9% sodium chloride + 5% dextrose (± 20mmol KCl)

Question 8

How do you calculate the maintenance fluids of a child? How is rate calculated?

Answer 8

• First 10kg of weight = 100ml/kg/day
• Next 10kg = 50ml/kg/day
• Every other kg = 20ml/kg/day

Rate (ml/h) = total fluids (ml) / 24

Question 9

How do you calculate deficit fluids?
How long is this given over?

Answer 9

Deficit % x 10 x kg
Usually given over 48 hours

Question 10

What is given for a fluid bolus and how much?

Answer 10

20ml/kg of 0.9% NaCl

(may give 10ml/kg if they can’t take as much)

Question 11

What fluids are given to a child in DKA?

Answer 11

10ml/kg 0.9% NaCl