Fluids, Prescribing and Vaccinations Flashcards
What is the amount of fluid e.g. Dioralyte given for oral rehydration?
50ml/kg/24 hours plus maintenance
What fluid is often prescribed IV in paediatrics?
0.9% saline / 5% dextrose
What type of fluid is commonly used in paediatric IV prescribing? Examples of this?
Crystalloids
Saline
Dextrose
Hartmanns
How do you calculate IV maintenance fluid requirements for children over 28 days old?
100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg for anything over 20kg up to max of 2L per day for girls, 2.5L per day for boys
What are sodium and potassium requirements per 24 hours?
Na 2-6mmol/kg per day
K 1-3mmol/kg per day
Good IV fluid choice for maintenance in fasting children?
0.9 % saline plus 5% dextrose plus K
4 conditions where maintenance requirements should be reduced to 50-75%?
SIADH
Fluid overload
Congestive heart failure
Renal failure with oliguria/anuria
What fluid do NICE recommend for maintenance?
0.9% saline
What percentage dehydration constitutes mild in infants and children?
5% infants, 3% children
Clinically what might indicate mild dehydration?
Dry membranes and pale, otherwise normal
What percentage indicates moderate dehydration in infants and children?
10% infants, 6% children
What clinical changes might occur in moderate dehydration?
Urine output reduced
Heart rate increased
Cap refill time increased
Grey, lethargic
What percentage constitutes severe dehydration in infants and children?
15% infants, 9% children
What changes occur in severe dehydration?
Skin tents when pulled
Blue and mottled appearance
BP Hypotensive with high cap refill
Altered mentation/coma
How do you calculate IV fluid replacement over 24 hours in kids based on the percentage they are dehydrated?
Total deficit = percentage dehydrated X weight X 10
Gives the mls required over 24 hours to rehydrate in addition to maintenance
