Many of the pediatric inpatients you care for will need intravenous fluids and electrolytes. This episode describes what you need to know before you order fluids or electrolyte replacement for your patient. We will discuss maintenance fluid needs and talk more in depth about what fluids to order and at what rate. We will also talk about managing patients with dehydration and how to replete fluids. Then we will discuss a few cases where we will work through some more common electrolyte derangements and discuss how to manage them. We will end with additional clinical pearls that will be helpful during your time on the inpatient pediatric service.

Introduction
Definition of maintenance fluid needs
Important considerations about maintenance fluids
Discussion regarding which fluids to order for different patient populations and at what rate to administer
Role of ADH in hospitalized patients
How to order a fluid bolus—amount, composition, and rate administered
Assessing your patient with dehydration utilizing physical exam findings, vital signs, and other objective data such as weight
Case scenarios: Identification and management of hyperkalemia and hypokalemia


Case #1- 12-year old with hyperkalemia following infection with influenza
Case #2- 2-year old child with history of neglect and malnutrition


Additional clinical pearls including the association between albumin and calcium, acidosis/alkalosis and potassium levels

Resources/Links:
 Clinical Practice Guideline: Maintenance Intravenous Fluids in Children | Pediatrics | American Academy of Pediatrics (aap.org)

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