Question

A 13 year old, 121 lb (55 kg) male presents with nausea and periumbilical abdominal pain and is diagnosed with appendicitis. Following an uncomplicated laparoscopic appendectomy, the patient is comfortable and stable, with vital signs in the normal range. The patient is not yet eating. Laboratory analysis shows electrolytes within normal limits and creatinine at pre-operative baseline. Which of the following is the most appropriate maintenance fluid and infusion rate for this patient?

A. Normal saline (0.9% NaCl) + 20 mEq KCl at 70 mL/h
B. Ringer's lactate at 70 mL/h
C. Normal saline (0.9% NaCl) at 95 mL/h
D. 5% dextrose and 1⁄4 normal saline (0.225% NaCl) + 20 mEq KCl at 95 mL/h
E. 5% dextrose and 1⁄4 normal saline (0.225% NaCl) + 20 mEq KCl at 120 ml/h

Answer 1

The most appropriate maintenance fluid and infusion rate for this patient would be normal saline (0.9% NaCl) at 95 mL/h.

Step-by-step explanation:

The most appropriate maintenance fluid and infusion rate for this patient would be option C, which is normal saline (0.9% NaCl) at 95 mL/h.

Normal saline is an isotonic solution that closely matches the concentration of electrolytes in the body fluids. Since the patient has an uncomplicated recovery and his electrolyte levels are within normal limits, there is no need for additional potassium supplementation (option A). Ringer's lactate (option B) is also an isotonic solution, but it contains lactate, which is unnecessary in this case. Option D and E both involve the use of dextrose, which is not necessary in a patient who is not yet eating.