DD33 Fluids Exam 33 Questions with Answers
When should children start having complementary feeds? - CORRECT ANSWER >6 months
When should
... [Show More] breastfeeding be stopped? - CORRECT ANSWER 2 years
How do you calculate the maintenance feeds feeds for children < 6 months who are unable to breastfeed? - CORRECT ANSWER 150 ml/kg/day F: 3-4 hourly
How do you calculate the maintenance feeds feeds for children 7-12 months who are unable to breastfeed? - CORRECT ANSWER 120 ml/kg/day F: 4-6 hourly
How do you calculate the maintenance feeds feeds for children >12 months who are unable to breastfeed? - CORRECT ANSWER 100 50 20 rule F: 6-8 hourly
100 ml/kg/day for the first 10kg
50 ml/kg/day for the next 10kg (10-20kg)
20ml/kg/day for >20kg
If 25 kg body weight ,maintenance fluid will be:
• 10x100(1st10kg)+10x50(2nd10kgbetween 10-20) + 5 x 20 (5 kg >20 kg BW) =
• 1000+500+100=1600ml
What should be done if the baby is NPO? - CORRECT ANSWER Maintenance fluid over 24 hours
*Ex: Prescription: '1080ml 1⁄2 DD at 45 ml/hr'*
What IV fluid do you give neonates? - CORRECT ANSWER Neonatalyte (10% glucose)
What IV fluid do you give for shock? - CORRECT ANSWER Ringers lactate
Normal saline
What IV fluid do you give for AGE? - CORRECT ANSWER 1/2 DD (5% glucose)
What IV fluid do you give for non-gastro maintenance? - CORRECT ANSWER PMS (5% glucose)
How do you make the ORF? - CORRECT ANSWER 1l Cooled boiled water
6 Teaspoons of sugar
I/2 Teaspoon of salt
When is diarrhoea season in the WC? - CORRECT ANSWER Feb - May
What are the complications of AGE? - CORRECT ANSWER - Dehydration
- Shock
Metabolicacidosis
hyper/ hypo-Na
hypo-K
hypo-Ca
hypo-Mg
Hypo/ hyperglycaemia
- Malnutrition
- Renal failure
- Haemolytic uremic syndrome
- Susceptibility to re-infection
- CNS (convulsions, venous sinus thrombosis)
- Death
SHOCK vs DEHYDRATION - CORRECT ANSWER SHOCK
LOC: Depressed or lethargic
Absent or weak pulses
CRT > 3 sec
Cool peripheries
Tachycardia >120
DEHYDRATION
LOC: Normal or lethargic
Normal pulse volume
CRT < 3sec
Normal HR or slight tachycardia <120
How do you manage shock? - CORRECT ANSWER A B C
GLUCOSE --- give glucose <3mmol/l
IV: Normal saline ---- 20 ml/kg
ASSES THE PATIENT
What should be done if you asses a patient with shock after initial management and they are still shocked? - CORRECT ANSWER IV: Normal saline 10 ml/kg
Check for signs of cardiogenic shock
What should be done if you asses a patient with shock after their 2nd dose of IV and they are still shocked? - CORRECT ANSWER IV: Normal saline 10 ml/kg
BC
IV Ceftriaxone
Start Inotropes
Check dextrostix
What should be done if you asses a shocked patient and they are not shocked anymore after initial therapy? - CORRECT ANSWER Asses hydration
Rehydration protocol
How do we classify dehydration? - CORRECT ANSWER No
Some [5%]
Severe [10%]
SOME D vs SEVERE D - CORRECT ANSWER SOME DEHYDRATION
- Restless & irritabile
- Sunken eyes
- Thirsty & drinks eagerly
- CRT < 2 secs
- Visible skin fold
SEVERE DEHYDRATION
- Sleepy or lethargic
- Sunken eyes
- Drink poorly
- CRT > 2 secs
- Skin fold > 2 secs
How do you manage AGE with no/some dehydration? - CORRECT ANSWER Oral rehydration fluid --- 4 hours
- calculate the amount
- give small volumes every 15 min
- Loose stools? add 10 ml/kg
NB: Continue breastfeeding
How do you manage AGE with severe dehydration? - CORRECT ANSWER Check blood glucose --- correct if it is < 3mmol/l
IV: 1/2 DD @ 20 ml/kg/hour
Transfer to L2 hospital
Monitor every 30 min until transfer
When do we prefer to use nasogastric tube for severe dehydration? - CORRECT ANSWER Wasted
Severe malnutrition
What is 1/2 DD? - CORRECT ANSWER 1/2 Darrow's Dextrose
What supplementation do you prescribe children with AGE? - CORRECT ANSWER Zinc
Vit A
KCl --- not to be given to children who have been shocked until renal fx has been reviewed.
When can children with AGE be discharged? - CORRECT ANSWER - Discharge weight > Admission weight
- Drinking well
- No vomiting in recent hours
- Bright eyed and alert
What is the difference between non-compensated vs compensated shock? - CORRECT ANSWER C: Normal BP
NC: Low BP
What must fluids used in children always contain? - CORRECT ANSWER Glucose
Except in resus
How do you manage shock when you cannot get an IV line in? - CORRECT ANSWER NGT
ORS @ 30 ml/kg/hour —— Normal patient
ORS @ 10 ml/kg/hour —— SAM
What should be done if ORT for AGE fail? - CORRECT ANSWER NGT —— 20 ml/kg/hour
Asses after 2 hours
BF allowed
But nothing else
What should be done if the child < 3 years or SAM & ORT failed? - CORRECT ANSWER NGT —— 10 mg/kg/hour
L2 hospital transfer
Did you look at the protocol on slide 34? - CORRECT ANSWER
How do we mange AGE with severe dehydration but the child has SAM? - CORRECT ANSWER NGT —— 10 mg/kg [Show Less]