Can someone please help me figure out these questions. I am about to start my last semester of my ADN
We were given a take home assignment to complete before our semester begins so there is no way to ask the instructor questions before it is due.
I am not sure of two of the questions. the first: calculate the hourly IV flow rate for a 27kg child receving maintance fluid.
c. 60 cc/hr
d. 70 cc/hr
I have been unable to find anything in my book regarding IV maintainance but in our power points, we have a formula for hydration maintainance. (not sure if is the same thing :uhoh21: ) based on that formula of 100 cc/kg for the first 10 kg, 50 cc for the second 10 and 20 for the remaining, I came up with 68.3 which I would go w/ C so as not to overload. Is this even the right formula or is there one for IV maintainance?
The second: a child is receving TPN. At the end of 8 hours, the nurse observes the solution and notes that 200 ml per 8 hrs is being infused rather than the ordered 300 ml. The nurse should adjust the rate so that how much will infuse during the next 8 hours?
a. 200 ml
b. 300 ml
c 350 ml
d. 400 ml
I chose B as it is not up to the nurse to increase rates of TPN and with children, rationalized that increasing by c or d would increase potential for complications. I would say to set it at 300 ml and notify the MD of the previous infusion. *(since notifying MD isn't an option, I went with B)
Any input would be greatly appreciated. I would really like to know if there are formulas for figuring out the questions as I'm sure to encounter similar situations in the future. I know the formula for adjusting IV flow rates but couldn't find one for TPN.
Thank you all so much for your help!!
Jan 11, '07
On the first question, calculate the hourly flow rate, there's a little formula that you need to use to figure out maintenance fluid for a child. It's based on the child's weight.
For the first 10kg, it's 4cc/kg
Then for the next 10 kg (so 10-20 kg) it's 2cc/kg
Then for each kg after that it's 1 cc
This formula is also useful to double-check an MD's order.
You should be able to figure it out from there. Good luck!
I'm editing this to add an example...
For a 34kg child I'd take the first 10kgx4cc which is 40
plus the second 10kgx2 which is 20 plus (already calculated) 40 which is 60
Then for the last 14kg I calculate 1 cc per kg, so 14 now add the 60
The maintenance fluid for a 34kg child is 74cc/1hr
Last edit by analee23 on Jan 11, '07