CASE NO.

1
A 60 year old female, weighing 60 kg, is admitted due to right upper quadrant pain and fever. She is
diagnosed to have acute cholecystitis and undergoes surgery. Following cholecystectomy, she is placed
on NPO (nothing per orem).
1. What is the estimated total body water of the patient? ECF? ICF? Blood volume?
A. Total Body Water (TBW)
= body weight (kg) x 50% = 60kg x 0.5 = 30.0 L
B. Extracellular Fluid Volume (ECF)
= body weight (kg) x 20% = 60kg x 0.2 = 12.0 L
C. Intracellular Fluid Volume (ICF)
= body weight (kg) x 30% = 60kg x 0.3 = 18.0 L
D. Total Blood Volume
= body weight (kg) x 8% = 60kg x 0.08 = 4.8 L
2. What is her total fluid requirement in 24 hours?
Total Fluid Requirement/24 hr = body weight x 35 mL = 60 kg x 35.0 mL = 2100 mL/24 hours
3. What commercially available intravenous fluid (IVF) should be given to her in 24 hours to meet
her requirements in terms of fluid and electrolytes?
Electrolyte Replacement:
Na
= 1 mEq/kg
K
= 1 mEq/kg
Cl
= 1.5 mEq /kg
4. What is the best parameter to be used to determine the adequacy of rehydration?
The most important parameter in determining the hydration status or the adequacy of
rehydration of a patient is urine output. Ideally, urine output is normal at 0.5 1 ml/kg/hr.