Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Holliday-Segar

Posted by Laura on November 2, 2010

If a baby is at 9kg, what is the fluid maintenance requirement needed in a day, and what would you set the rate on the pump to be?

100mL/kg for first 10 kg  = 900mL

50mL/kg for 2nd 20 kg = 0

20mL/kg for remainder of wt in kg = 0

Total for this example = 900mL in a day

1000mL divided by 24 hrs = 37.5 mL/hr

(A shorter way to see this: For the first 10 kg of weight, give 100 mL/kg fluid.  For 11-20 kg, give 1000 mL + 50 mL/kg for each kg over 10 kg. For a child over 20kg, give 1500mL + 20mL/kg for each kg over 20 kg)

Maintenance requirements for water of individuals is determined by their caloric expenditure.

Problem: The infant on the floor is currently producing 1 diarrheal stool q 3 h and refusing to drink. Clinical findings of dry mucous membranes, poor skin turgor, markedly decreased urine output, and tachycardia with normal BP and capillary refill suggest 10% fluid deficit. Rectal temperature is 37° C; serum Na, 136 mEq/L; K, 4 mEq/L; Cl, 104 mEq/L; and HCO3, 20 mEq/L. The doctor has ordered fluid volume replacement for this 25kg child. What would the IVF maintenance rate be set at?

2 Responses to “Holliday-Segar”

  1. Laura said

    Hi Kristin,
    I see what you are saying. With a 9 kg infant – you are right!
    Thank you!

  2. Kristin Hanak said

    I noticed a problem with the calculation at the top of this entry. The fluid maintenance for a 9kg infant would not be 1000 mL/day it would be 900 mL/day. You multiply the weight up to 10 kg by 100 mL/kg/day- so 9kg x 100 mL/kg/day would be 900 mL/day. A 5 kg child would be 5 kg x 100 mL/kg/day= 500 mL/day. If a child is 15 kg you would multiply 10 kg x 100 mL/kg/day and 5 kg x 50 mL/kg/day and get 1250 mL/day,.

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