Fluid Calculation

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

14. What is the hourly IV rate for a child weighing 7 pounds? (Round kg to nearest tenth, round mL to nearest whole number.) 13 mL/hr 29 mL/hr 7 mL/hr 22 mL/hr

13 mL/hr Rationale for correct response: Maintenance fluids for less than 10 kg = wt x 100 ml/kg/day; divid by 24 hours for hourly rate 7 pounds = 3.18 kg. Round to nearest tenth = 3.2 kg x 100 = 320 ml a day = 13.3 mL per hour

8. What is the total daily maintenance fluids for a child weighing 18.2kg? 1410 ml/day 910 ml/day 1820 ml/day 1910 ml/day

1410 ml/day Rationale for correct response: 1000 + (50 x 8.2) = 1410

9. What is the total daily maintenance fluids for a child weighing 57 pounds? 1618 mL/day 2018 mL/day 2240 mL/day 2590 mL/day

1618 mL/day Rationale for correct response: Maintenance fluids for a child 100 50 20 formula 57 pounds x 1 kg/2.2 pounds = 25.9 kg 1000 + 500 + 118 = 1618

6. The nurse is caring for a 1-year-old child who weighs 10 kg. The nurse would expect a minimum urine output of _______ ml over 12 hours. (Respond with a whole number only).

180 Rationale for correct response: Urine output for an infant or young child is 1.5 to 2 ml/kg/hr 10 kg x 1.5 (minimum) = 15 ml/hr x 12 = 180 ml

7. The nurse is caring for a 7 pound newborn. The nurse would expect a minimum of _____ ml of urine over 8 hours. (Round kg to nearest 10th. Answer in ml is whole number only.)

38 Rationale for correct response: Minimum urine out put for an infant is 1.5 to 2 ml/kg/hr. 7 pounds = 3.18 kg = 3.2 kg x 1.5 ml/hr = 4.8 ml/hr x 8 hours = 38.4 = 38 ml

12. What is the hourly IV rate for maintenance fluids for a child weighing 22 pounds? (Round answer to nearest whole number.) 42 ml/hr 64 ml/hr 21 ml/hr 46 ml/hr

42 ml/hr Rationale for correct response: Using the 100 50 20 formula, 22 pounds = 10 kg 10 x 100 = 1000 divided by 24 = 42 ml/ hr

10. What is the daily maintenance fluids for an infant weighing 4.5 kg? 450 mL/day 225 mL/day 204 mL/day 90 mL/day

450 mL/day Rationale for correct response: Maintenance fluids for child less than 10 kg = 100 ml/kg/day 4.5 kg x 100 ml/kg/day = 450 ml per day

5. The nurse is caring for a 12-year-old who weighs 88 pounds. The nurse would expect minimum of _______ ml of urine over 12 hours. (Use whole numbers only).

480 Rationale for correct response: 40 kg x 1 ml/hour = 40 ml x 12 hours = 480 ml in 12 hours

The nurse is caring for a child, with no previous medical history, who weighs 10 kg and is moderately dehydrated. The prescription by the provider is to give an IV bolus over 20 minutes. What would the nurse set the IV pump in at mL/hr to deliver the bolus in the prescribed amount of time? 100 mL/hr 200 mL/hr 300 mL/hr 600 mL/hr

600 mL/hr The child needs 200 ml over 20 minutes as he weighs 10 kg and requires 20 ml/kg. To set the pump, the volume to be infused would be 200 ml, over 20 minutes and that would be 600 ml/hr.

13. After the bolus has been infused, what is the hourly IV rate for a child weighing 45 kg? (Round the ml to the nearest whole number.) 83 ml/hr 100 ml/hr 115 ml/hr 73 ml/hr

83 ml/hr 45 kg 1000 + 500 + (20 x 24) = 1980 divided by 24 = 82.5 = 83 ml/hr

An infant, with no medical history, is in the emergency room, for moderate dehydration (8%) and weighs 5.6 kg. The parents inform the nurse that the last wet diaper was 6 hours ago and that the child had been vomiting for the past 24 hours but has had no emesis for the past 3 hours. Caregiver states that the infant is refusing to drink anything. The nurse notes that the infant's heart rate is 154 beats per minute, respiratory rate is 56 breaths per minute, blood pressure is 92/65, capillary refill is 3 seconds, skin is cool and dry, skin turgor is decreased, fontanel is slightly sunken, mucous membranes are dry, and the infant is quiet and does seem to engage in the environment with parents. What would the nurse expect for the initial intervention for this child? Administer 112 ml NS IV over 5 to 20 minutes Administer 112 ml NS with 20meq of K+ IV over 5 to 10 minutes Give 280 ml of oral replacement fluids over 4-6 hours Start IV fluids D5 NS at 23 ml/hr

Administer 112 ml NS IV over 5 to 20 minutes Rationale for correct response: This patient is presenting with cool and dry skin, poor skin turgor, history of vomiting, and not engaged with the environment. The infant is moderately dehydrated and vital signs are stable; but due to refusing to drink the initial treatment will be IV with rapid replacement over 5 to 20 minutes. RAPID is negative. Rapid replacement = 20 ml/kg x weight over 20 minutes 20 ml/kg x 5.6 kg over 20 minutes = 112 ml

3. An 11-month-old infant has been admitted to the emergency room with a 4 day history of diarrhea and severe dehydration (10%). The child weighs 8.8 kg. The parents inform the nurse that the last wet diaper was more than 24 hours ago and that the child has refused all foods but had about 2 ounces of tap water 5 hours ago. The nurse notes on the child's assessment that the heart rate is 182 beats per minute, respiratory rate is 56 breaths per minute, blood pressure is 62/40, capillary refill is greater than 4 seconds, skin is cool and clammy, skin turgor is poor, fontanel is sunken, and the child is difficult to arouse or keep awake. What would the nurse expect for the initial intervention for this child? Administer 176 ml NS over 5 to 10 minutes. Administer 176 ml NS over 30 minutes. Start IV fluids of D5 NS at 36 ml/hr Administer 880 ml oral fluids over 4-6 hours

Administer 176 ml NS over 5 to 10 minutes. Rationale for correct response: This patient is showing signs of hypovolemic shock with tachycardia, hypotension, oliguria, and tachypnea therefore fluids need to be given over 5 to 10 minutes This patient is also showing signs of hypotonic dehydration with cold & clammy skin, poor skin turgor, and lethargic. Rapid replacement fluid = 20 ml/kg over 5 to 10 minutes. 20 ml/kg x 8.8 kg = 176 ml RAPID is positive

1. A 13-year-old child has been admitted to the emergency room after collapsing during football practice with moderate dehydration (8%). The child weighs 30 kg. The coach informs the nurse that they had been practicing all afternoon and that the only water available was inside the school which had been locked up for the past 4 hours. The nurse notes on the child's assessment that the heart rate is 132 beats per minute, respiratory rate is 26 breaths per minute, blood pressure is 112/78, capillary refill is 3 seconds, skin is dry, and mucous membranes are dry. The child is able to follow commands. What would the nurse expect for the initial intervention for this child? Start IV fluids D5 NS at 71 ml/hr Administer 600 ml NS IV over 10 to 20 minutes Give 1500 ml oral replacement fluids over 4-6 hours Administer 600 ml NS IV over 5 to 10 minutes.

Administer 600 ml NS IV over 10 to 20 minutes Summary of rationale: This patient is dehydrated and needs fluids. Although, the child is able to follow commands, he is lethargic therefore oral fluids would be contraindicated. The child needs a bolus of IV fluids but since the child is stable the bolus may be administered over 5 to 20 minutes. Rapid fluid bolus is calculated at 20 ml/kg. RAPID is negative

15. The nurse has given her patient the prescribed bolus. What is the priority nursing action now? Obtain the prescribed blood work Document the current vital signs Assess the patient Ask the patient if they feel better

Assess the patient After the bolus is given, the nurse needs to reassess the patient, which would include current vital signs, vomiting, appearance, urine output, etc.

2. A 21-month-old child who weighs 11.7 kg has been admitted to the emergency room with moderate dehydration. Caregiver states she has vomited twice today, the last time being about 6 hours ago. The last wet diaper was about 4 hours ago and the child last had something to drink about 4 hours ago. The nurse notes on the child's assessment that the heart rate is 142 beats per minute, respiratory rate is 38 breaths per minute, Blood pressure is 102/76, capillary refill is less than 3 seconds, skin is cool and dry, skin turgor is decreased. The child is irritable, crying, making some tears and is easily consoled. What would the nurse expect for the initial intervention for this child? Give 1170 ml of oral replacement fluids over 4-6 hours Administer 234 ml NS over 5 to 20 minutes Start IV fluids D5 NS at 45 ml/hr Give 585 ml over the next 4 to 6 hours

Give 1170 ml of oral replacement fluids over 4-6 hours Rationale for correct answer: This patient is presenting with moderation dehydration (skin cold & dry, decreased skin turgor, and irritable but consolable and making tears.) However, this patient is awake and alert with moderate dehydration so oral re-hydration would be the treatment of choice. 100 ml/kg over 4 to 6 hours RAPID is negative


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