IV FLUID BOLUS

[RNSAINT41]

When calculating an IV fluid bolus for a pediatric patient how do you round the volume? Say a 12 pound pediatric patient is ordered a NS fluid bolus 20ml/kg I use dimensional analysis and get 109.090 ml as my answer but would it be rounded to 109 ml or 109.1ml? thanks

[NICU Guy, BSN, RN]

Whatever your pump allows. If you can program it for 109.1, then use that. The 0.1 mL is pretty insignificant and will not make a significant difference in your treatment.

[offlabel]

Fill the burette with 100 mls and let it rip. Free flow or pump to 999

[KelRN215, BSN, RN]

0.1 mL is a completely insignificant amount of fluid. You're going to flush the IV with way more than that once the bolus is done. We had 150 mL bags of normal saline when I worked in the hospital so I'd spike one of those for this bolus. I'd program the pump to 109 mL because I don't recall that pumps allowed VTBI to be entered with any decimals. We usually administered our boluses over an hour.

[NotReady4PrimeTime, RN]

This is obviously a school question. In the real world the doc is going to order 110 mL.

[neonn965]

In reality it doesn't matter how I round it because the order will be in the computer for whatever the MD/NP wants. I'll do the calculation for safety in order to verify the order but that's it. Fluid boluses are pretty much always ordered as whole numbers though and honestly I've seen them rounded up and down. A fraction of a mL when it comes to a NaCl bolus is not relevant.

[HiddencatBSN, BSN]

This is obviously a school question. In the real world the doc is going to order 110 mL.

Or if you are taking care of peds in a no-peds specific unit, they're going to order a 100ml bag.

Most pumps I've used allow tenths of an ml for volume but not rate.