A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the physician has ordered
The formula the physician used was for maintenance fluids: 1,000 mL for 10 kg of body weight plus 50 cc for every kg over 10 for 24 hours. Replacement fluid is the percentage of lost bodyweight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, what should this child's hourly IV rate for 24 hours be? 1. 88
2. 86
3. 81
4. 83
2
Rationale 1: Maintenance need for 13 kg is 1,000 + (50 [×] 3), or 1,150 mL/24 hours. Add to this the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1,150 + 910 = 2,060 for 24 hours. 2,060/24 = 86 cc per hour.
Rationale 2: Maintenance need for 13 kg is 1,000 + (50 [×] 3), or 1,150 mL/24 hours. Add to this the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1,150 + 910 = 2,060 for 24 hours. 2,060/24 = 86 cc per hour.
Rationale 3: Maintenance need for 13 kg is 1,000 + (50 [×] 3), or 1,150 mL/24 hours. Add to this the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1,150 + 910 = 2,060 for 24 hours. 2,060/24 = 86 cc per hour.
Rationale 4: Maintenance need for 13 kg is 1,000 + (50 [×] 3), or 1,150 mL/24 hours. Add to this the replacement fluid loss = 7 (% of total body weight lost) × 10 = 70 mL/kg/24 hours (70 × 13 = 910). 1,150 + 910 = 2,060 for 24 hours. 2,060/24 = 86 cc per hour.
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