Pediatric IV Fluids Flashcards
Define “sensible loss” as it relates to daily fluid replacement
Sensible losses = urine and stool; losses that are perceived by the senses and can be measured
55 mL lost per 100 kcal of energy expenditure
Define “insensible loss” as it relates to daily fluid replacement
Insensible losses = skin and respiratory; loss that is not perceived by the individual and cannot usually/easily be measured
45 mL lost per 100 kcal of energy expended
[in pts >10 kg, insensible loss is often calculated using surface area, which is 300-400 mL/m^2]
Examples of pediatric conditions in which insensible losses may be increased
Skin — burns, fever, phototherapy, prematurity, radiant heater, sweat
Lungs — tachypnea, tracheostomy
Examples of pediatric conditions in which sensible losses may be increased
GI tract — diarrhea, emesis, ileostomy, NG suction
Renal — polyuria
________ method = most common method used to calculate fluids
Holliday-Segar
How does the Holliday-Segar method define the relationship between daily maintenance fluid requirements and daily kcal/kg of energy expended?
Approximately 100 mL of exogenous water is needed to replace insensible and sensible losses for every 100 kcal/kg of energy expended
How are HOURLY maintenance IV fluid rates calculated using the Holliday-Segar method?
< 10 kg: 4 mL/kg/hr
10-20 kg: 40 mL + 2 mL/kg for every kg >10kg
> 20 kg: 60 mL + 1 mL/kg for every kg >20 kg
How are DAILY maintenance IV fluid rates calculated using the Holliday-Segar method?
<10 kg: 100 mL/kg/day
10-20kg: 1000 mL + 50 mL/kg/day for every kg>10
> 20 kg: 1500 mL + 20 mL/kg/day for every kg >20
Calculate the daily chloride, sodium, and potassium needs of a normal, healthy child
Na and Cl = 3 mEq per 100 cc water
K = 1-2 mEq per 100 cc water
List the 2 most common isotonic fluids used as boluses in the IV treatment of dehydration
Lactated ringers
Normal saline
The AAP recommends that patients 28 days to 18 years of age requiring maintenance IV fluids should receive _______ solutions with appropriate KCl and dextrose because they significantly decrease the risk of developing ________
Isotonic; hyponatremia
Concentration (mEq/L) of sodium and chloride, as well as percentage of NaCl in Normal Saline
Na = 154 mEq/L Cl = 154 mEq/L
0.9% NaCl
Well-appearing child, normal breathing pattern, capillary refill <2 seconds, and instant recoil on skin turgor exam. Which of the following characterizes their degree of dehydration?
A. Mild (3-5%)
B. Moderate (6-9%)
C. Severe (>10%)
A. Mild (3-5%)
Ill-appearing but non-toxic appearing child, breathing pattern increased, cap refill 2-4 seconds, skin recoil of 2 seconds. Which of the following characterizes their degree of dehydration?
A. Mild (3-5%)
B. Moderate (6-9%)
C. Severe (>10%)
B. Moderate (6-9%)
Lethargic appearing child with increased, deep breathing pattern, capillary refill >4 seconds, skin recoil >2 seconds. Which of the following characterizes their degree of dehydration?
A. Mild (3-5%)
B. Moderate (6-9%)
C. Severe (>10%)
C. Severe (>10%)
