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Pediatric Fluids Electrolytes QA

The document discusses fluid and electrolyte management in pediatrics, highlighting differences in body water composition among neonates, infants, and older children, and the reasons infants are more prone to dehydration. It outlines methods for calculating maintenance fluid requirements, classifying dehydration, and appropriate fluids for resuscitation and maintenance. Additionally, it addresses common electrolyte abnormalities, fluid management in neonates, and risks associated with over-resuscitation.

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Malueth Angui
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28 views1 page

Pediatric Fluids Electrolytes QA

The document discusses fluid and electrolyte management in pediatrics, highlighting differences in body water composition among neonates, infants, and older children, and the reasons infants are more prone to dehydration. It outlines methods for calculating maintenance fluid requirements, classifying dehydration, and appropriate fluids for resuscitation and maintenance. Additionally, it addresses common electrolyte abnormalities, fluid management in neonates, and risks associated with over-resuscitation.

Uploaded by

Malueth Angui
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Fluids and Electrolytes in Paediatrics – Questions

& Explanations
Q: What are the major differences in body water composition between neonates, infants, and older
children?
A: Neonates: ~75–80% body water, Infants: ~70%, Older children: ~60%. Higher ECF proportion in
neonates → prone to rapid fluid shifts.

Q: Why are infants more prone to dehydration than adults?


A: Higher surface area-to-volume ratio, higher metabolic rate, immature kidneys, greater insensible
water losses.

Q: How do you calculate maintenance fluid requirements in children (Holliday–Segar method)?


A: 100 ml/kg for first 10 kg, 50 ml/kg for next 10 kg, 20 ml/kg for each kg above 20 kg.

Q: How do you classify dehydration clinically in children?


A: Mild (3–5% weight loss), Moderate (6–9%), Severe (≥10%). Clinical signs: sunken eyes, dry
mucosa, tachycardia, delayed cap refill, shock.

Q: A 10-kg child presents with 10% dehydration. Calculate the fluid deficit.
A: 10% of 10 kg = 1 kg water loss ≈ 1000 ml deficit. Replace over 24–48 hours + maintenance
fluids.

Q: What are the appropriate fluids for resuscitation vs maintenance in paediatrics?


A: Resuscitation: isotonic crystalloids (0.9% saline, Ringer’s lactate). Maintenance: isotonic fluids
(0.9% saline or Ringer’s + 5% dextrose + KCl if not oliguric).

Q: Why is 0.18% saline (hypotonic solution) no longer recommended for maintenance fluids?
A: Risk of hospital-acquired hyponatremia → seizures, cerebral edema.

Q: What are the electrolyte abnormalities commonly seen in pyloric stenosis?


A: Hypochloremic, hypokalemic metabolic alkalosis due to persistent vomiting.

Q: Causes of hyponatremia in children?


A: Diarrhea, vomiting, SIADH (meningitis, pneumonia, post-op), excessive hypotonic fluids.

Q: Causes of hyperkalemia in children?


A: Renal failure, tissue breakdown (hemolysis, rhabdomyolysis, burns), acidosis,
potassium-sparing diuretics.

Q: How does fluid management differ in neonates compared to older children?


A: Neonates require more careful titration: higher TBW, immature renal handling, avoid fluid
overload. Start ~60–80 ml/kg/day and increase gradually.

Q: What fluid and electrolyte problems are common in intestinal obstruction?


A: Dehydration, hypochloremic alkalosis, hypokalemia due to vomiting and sequestration of fluids in
bowel loops.

Q: How would you manage electrolyte balance in a child with a high-output stoma?
A: Replace stoma losses ml-for-ml with isotonic fluids containing Na+, K+, and bicarbonate; monitor
weight and electrolytes closely.

Q: What is the risk of over-resuscitation with crystalloids in neonates?


A: Pulmonary edema, patent ductus arteriosus exacerbation, necrotizing enterocolitis, intracranial
hemorrhage.

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