IV therapy

  1. I am confused. I am a new grad and asked the question of " How can you tell if a patient is getting too much IVF?" I know it goes by kg. I tried to look this up and had no luck. I believe it is for a bolus 5cc/kg and for maintenance something like 3cc/kg. I asked my preceptors and nobody knew the exact formula. they said they can tell if it is too much but they do not know the exact formula. Can anybody please help me. I don't want ot be an ignorant pediatric nurse ,considering IVF is the most common intervention.
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  2. 6 Comments

  3. by   nurs4kids
    Linda,
    I do not know the exact answer either. I, like your preceptors, just know if it sounds too high/too low. Most importantly is whether the kidneys are perfusing the fluid you're infusing. Watching for edema and urine output is most important. There's some formula the docs use and I'm not sure what it is..i've seen it written, but it looks terribly confusing..lol. As a doc for the formula, I'm sure they will tell ya.
  4. by   bergren
    Pediatric Fluid maintenance (total IV and PO) according to Harriet Lane Handbook

    100cc /kg for first 10 kg,
    50 cc/kg for next 10 kg
    20 cc /kg for remaining of kg

    So a kid who weights 33 kg
    1000 for first 10 kg
    500 for next 10
    260 for remaining
    _________________
    1760 /24 hours total po + IV

    If NPO, IV at 73 cc per hour if on full maintenance. Kids who are being rehydrated may be given fluids at 1 1/2 times maintenance. Kids who are in CHF may be at 2/3 maintenance.

    I found another source that gave 25 cc per kg for the remaining kg, but all the teritiary care Children's Hospitals I have worked in used the Harriet Lane formula.

    I highly recommend the Harriet Lane Handbook. It has invaluable information in just the right amount for a quick lookup. When you use it as a reference to challenge a resident about their plan, they do not question the source. It is now availalbe for download and for the PDA.
  5. by   WalMart_ADN
    we have harriets all over my floor, and that is what the residents use to write their med orders. that is also the formula we use for maintenence. kids that are getting chemo sometiems go for 2x maintence for prehydration, fyi
  6. by   nurs4kids
    I third the vote for Harriet Lane! Great advice, Bergren!
  7. by   Darlene K.
    Harriet Lane gets my vote!
  8. by   IRISHBREAD
    HURRAH FOR HARRIET!!!! EVERY PEDIATRIC UNIT SHOULD HAVE ONE AVAILABLE SO THAT YOU CAN CHECK THAT YOU ARE GIVING THE CORRECT AMOUNT OF FLUIDS AND FOR CHECKING THE DOSE OF MEDICATIONS--SOMETIMES MD'D CALCULATE IT WRONG AND THE PHARMACY DOES NOT CATCH IT. ALSO I WOULD RECOMMEND A PALS COURSE. IT IS NOT DIFFICULT AND EXTREMELY HELPFUL IF YOU ARE WORKING WITH CHILDREN

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