What is the most appropriate initial management of child?1. A six-year-old girl admitted for elective surgery and is made NPO (she is not allowed to drink or eat anything). She weighs 21 kg (height is 54 inches). Write an order for her IV fluids prior to surgery.

2. A two-year-old has sustained a severe closed head injury and is comatose. He weighs 14 kg. What factors need to be considered when calculating his daily water requirements? How would this patient’s fluid requirements differ from that of a 5-month-old girl admitted with fever to 39.5° C and marked tachypnea?

3. A seven-month-old infant has had fever, vomiting, and diarrhea for the past 24 hours. How would you determine whether to admit this patient to the hospital for intravenous fluids?

4. An infant weighing 8 kg is estimated to be 12% dehydrated. What is the calculated fluid deficit and how should it be replaced? What IV solution(s) should be used? What laboratory tests should be ordered?

5. A two-month-old infant is brought to the Emergency Department because of seizures. He has had diarrhea for five days and has been fed only water and apple juice. What might be the cause of the seizures and how should they be treated?

6. A nine-month-old infant has diarrhea and signs of moderate dehydration. His electrolytes are Na+ 162, K+ 5.6, Cl- 122, and bicarbonate 12. During IV rehydration the patient has a generalized seizure. What is the probable cause of the seizure? How should it be treated?

7. A nine-month-old infant has vomiting and diarrhea. He has dry mucous membranes and decreased tearing and urination. What type(s) of liquids would you recommend that the mother give to this infant and how often?

8. A nine-year-old child with diabetic ketoacidosis has the following electrolytes: Na+ 132, K+ 5.4, Cl- 103, and Bicarb 9. As the fluid deficit is corrected, what is likely to happen to the serum K? How should this be managed?

9. A nine-month-old girl presents with two days of vomiting and diarrhea. She is listless and her heart rate is 210. What is the most appropriate initial management of this child?


 

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