Pediatric Fluids & Electrolytes

Question 1

Mild Dehydration

Answer 1

infants 1-5%
children 1-3%

Question 2

Moderate Dehydration

Answer 2

infants 6-9%
children 4-6%

Question 3

Severe Dehydration

Answer 3

infants > 10%
children > 6%

Question 4

Severe Shock (Dehydration)

Answer 4

infants > 15%
children > 9%

Question 5

Severity of Dehydration

Answer 5

(pre-illness weight in kg - illness weight in kg) / (pre-illness weight in kg)

Question 6

Fluid Deficit in L

Answer 6

% dehydration x pre-illness weight / 100

Question 7

Dehydration Treatment - Principles

Answer 7

goal - restore fluid and electrolyte balance in combo

severity of hydration dictates strategy

Question 8

Mild-to-Moderate Dehydration - Treatment of Choice

Answer 8

oral rehydration therapy

Question 9

Severe Dehydration - Treatment of Choice

Answer 9

IV fluids

Question 10

ORT - Dosing for Mild Dehydration

Answer 10

50 mL/kg over 4 hrs

and additional 10 mL/kg for each loose stool or vomiting episode

Question 11

ORT - Dosing for Moderate Dehydration

Answer 11

100 mL/kg over 4 hrs

and additional 10 mL/kg for each loose stool or vomiting episode

Question 12

IVF - Phase 1 Dosing

Answer 12

bolus doses of 10-20 mL/kg/dose of NS or LR over 30-60 min

repeat up to 3 times

Question 13

IVF - Phase 2 Dosing

Answer 13

replace fluid deficit over 8 hrs
provide maintenance rate over next 16 hrs

Question 14

Fluid Replacement - Monitoring Parameters

Answer 14

normalization of BP
adequate urine output
improvement of S&S
normalization of labs

Question 15

IVF - Components

Answer 15

sodium
potassium
dextrose

Question 16

D10W - Indications

Answer 16

neonates or infants with hypoglycemia

Question 17

Potassium - Precautions

Answer 17

neonates
renal failure

Question 18

Maintenance IVF in Patients < 10 kg

Answer 18

40 mL/kg/hr

Question 19

Maintenance IVF in Patients 10-20 kg

Answer 19

40 mL/hr + 2 mL/kg/hr x (weight - 10 kg)

Question 20

Maintenance IVF in Patients > 20 kg

Answer 20

60 mL/hr + 1 mL/kg/hr x (weight - 20 kg)

Question 21

Ondansetron - Gastroenteritis Dosing

Answer 21

0.15-0.3 mg/kg/dose for patients > 6 months
2 mg/dose for patients 8-15 kg
4 mg/dose for patients 15-30 kg
8 mg/dose for patients > 30 kg

Question 22

Ondansetron - Adverse Effects

Answer 22

QTc prolongation
arrhythmias

Question 23

Zinc - Dosing

Answer 23

10 mg/day for 10-14 days for patients < 6 months
20 mg/day for 10-14 days for patients 6 months or older