PAEA Surgery End Of Rotation (EOR) Practice Exam

Following the 421 fluid replacement rule, what is the fluid replacement rate for each additional kg over 20 kg?

1. 2 mL/kg

2. 1 mL/kg

3. 4 mL/kg

4. 0.5 mL/kg

The correct answer is: 1 mL/kg

The fluid replacement rate following the 421 fluid replacement rule involves calculating the appropriate volume of fluids for a child based on their weight. According to this rule, for children weighing more than 20 kg, the fluid requirement is determined by the first 20 kg receiving 1000 mL (for the first 10 kg), plus an additional 500 mL for the next 10 kg, totaling 1500 mL for 20 kg. For each additional kilogram beyond 20 kg, the replacement rate is 20 mL/kg for those first 20 kg plus an additional 1 mL/kg for every kg over 20 kg. Therefore, the correct answer indicates the rate established for additional weight beyond the initial 20 kg thresholds. Using this understanding of fluid requirement calculations provides clarity on why the answer of 1 mL/kg is fitting for additional weight, distinguishing it clearly from the other options, which do not align with this established measurement for fluid replacement after reaching 20 kg.