A 14-month-old is brought to the clinic with vomiting and diarrhea and mild dehydration. The child weighs 10 kg and has the following lab results: Sodium 128 mmol/L (Normal: 134-14... A 14-month-old is brought to the clinic with vomiting and diarrhea and mild dehydration. The child weighs 10 kg and has the following lab results: Sodium 128 mmol/L (Normal: 134-146), Potassium 3.3 mmol/L (Normal: 3.5-5.1), Chloride 94 mmol/L (Normal: 97-108), Bicarbonate 12 mmol/L (Normal: 21-28). How much intravenous fluid (ml/day) should be given?
Understand the Problem
The question presents a clinical scenario of a 14-month-old child with vomiting and diarrhea, leading to dehydration and electrolyte imbalances. We need to calculate the appropriate daily intravenous fluid requirement for this child, taking into account their weight and the degree of dehydration.
Answer
Approximately 1000 ml/day of intravenous fluids should be administered based on the Holliday-Segar formula.
The child should receive approximately 1000 ml of intravenous fluids per day. This is calculated by using the Holliday-Segar formula, which estimates maintenance fluid requirements based on weight: 100 ml/kg for the first 10 kg of body weight.
Answer for screen readers
The child should receive approximately 1000 ml of intravenous fluids per day. This is calculated by using the Holliday-Segar formula, which estimates maintenance fluid requirements based on weight: 100 ml/kg for the first 10 kg of body weight.
More Information
The Holliday-Segar formula is a common method used to estimate maintenance fluid requirements in pediatric patients. Additional fluids may be needed to correct dehydration and ongoing losses. The lab values indicate hyponatremia, hypokalemia, and metabolic acidosis, which need to be addressed carefully during fluid management.
Tips
When calculating fluid requirements, it's important to consider the patient's weight, degree of dehydration, ongoing losses, and electrolyte abnormalities. Always reassess the patient's clinical status and lab values regularly to adjust fluid and electrolyte therapy accordingly. Correction of sodium should not exceed 8-10 mEq/L/day.
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