Fluid/Electrolytes

Question 1

Flaccid paralysis, hypotension, confusion, coma…

Electrolyte abnormality?
Treatment?

Answer 1

Hypermagnesemia (symptomatic)

Tx:
Calcium gluconate/calcium chloride… followed by hydration/diuresus –> dialysis if renal dysfunction

Question 2

Gastric fluid losses metabolic derangement?

Answer 2

hypOkalemic, hypOchloremic, hypERnatremic metabolic ALKALOSIS

Question 3

Post-partum hemorrhage –> hypopituitarism and hypotension… Diagnosis? Electrolyte abnormality?

Answer 3

Sheehan’s syndrome

Electrolyte abnormality: hypOnatremia

Question 4

What is the fluid resuscitation rate and choice for a 5kg infant with pyloric stenosis?

Answer 4

30cc/hr of D5 1/2NS +20KCL

Note: 1.5x maintenance rate is used for pyloric stenosis due to nausea, vomiting and decreased oral intake