A 5-year-old with pneumonia is improving but remains on intravenous maintenance fluid. Sodium has fallen from 139 to 134 mmol/L, weight is up 2%,

Question

A 5-year-old with pneumonia is improving but remains on intravenous maintenance fluid. Sodium has fallen from 139 to 134 mmol/L, weight is up 2%, urine output is adequate and oral intake is restarting. What prescription review is most appropriate?

Accepted Answer

Stop unnecessary IV fluid or prescribe reduced-rate isotonic glucose-containing maintenance fluid

Answer

Keep IV fluid unchanged until sodium falls below 125 mmol/L or neurological symptoms appear

Answer

Add repeated saline boluses despite weight gain and absence of circulatory compromise

Answer

Continue full-maintenance hypotonic fluid because urine output proves free-water excretion is normal

Answer

Add potassium before confirming ongoing urine output and the current serum concentration

Pre-renal AKI — RACP Paediatrics MCQ

A 5-year-old with pneumonia is improving but remains on intravenous maintenance fluid. Sodium has fallen from 139 to 134 mmol/L, weight is up 2%, urine output is adequate and oral intake is restarting. What prescription review is most appropriate?