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C. Hammond RN, MN
Volume is Important
Needed for all metabolic processes Imbalance results in negative health consequences Delicate requirements of pediatric patients
Those with the greatest proportion of body water are most sensitive to changes and imbalances We have to ensure we are providing an adequate amount of fluid to maintain optimal body functioning (oral, IV, feeding tubes) This is a particularly delicate balance for children and infants because they have a greater proportion of body fluids, high metabolisms with more fluid output relative to size, and small sizes which puts them at greater risk for developing fluid imbalances, particularly dehydration, than adolescents and adults. So, they require relatively more fluids to maintain balance. Many hospitalized children demonstrate or can develop fluid imbalances during their stay. Therefore, as nurses, we need to develop an understanding of the fluid requirements of children in order to prevent problems, or take appropriate action to deal with problems.
Lets Practice!
1) 7
year
old
Jane
is
23
kg.
What
is
the
minimum
amount
of
uid
she
should
drink?
2) 4
day
old
Ben
has
an
IV.
If
he
is
3.2
kg,
what
is
the
hourly
rate
the
IV
should
be
infusing
at
to
maintain
his
uid
requirements?
Answers
23kg
4
ml
x
10kg
=
40
2
x
10
=
20
1
x
3
=
3
40+
20
+
3=
63ml/hr
or
1512ml/day
(1.5L)
Summary
Our bodies rely on maintaining adequate fluid volume Pediatric patients are more sensitive to changes in volume We can use the 4-2-1 Rule to calculate basic fluid maintenance requirements in uncomplicated pediatric cases All of our metabolic processes and body functions rely on maintaining the appropriate volume and composition of fluid in our bodies Adults and children differ significantly in their fluid requirements Because of their higher metabolic rate, greater proportion of body fluid, and small sizes, children require relatively more fluid to maintain their requirements Ensuring adequate fluid intake is an essential for pediatric patients