A child weighs 8 kg. Using the 4-2-1 rule, what is the maintenance fluid rate per hour?

Answer and explanation

Correct answer: D. 32 mL/hour

  1. Step 1: 4-2-1 rule: 4 mL/kg/hour for the first 10 kg, 2 mL/kg/hour for the next 10 kg, 1 mL/kg/hour for each kg above 20 kg.
  2. Step 2: For 8 kg the rate is 32 mL/hour.
Answer
32 mL/hour.
Why not the others: '16 mL/hour' gives 2 mL/kg for the whole weight; '42 mL/hour' adds an extra 10 mL; '40 mL/hour' mixes the weight bands incorrectly.

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