4-2-1 pediatric maintenance fluid rule
NCLEX-RN glossary · Health Promotion And Maintenance
Definition
A formula to calculate the hourly maintenance fluid rate: 4 mL per kg for the first 10 kg, 2 mL per kg for the next 10 kg, and 1 mL per kg for every kg above 20.
4-2-1 pediatric maintenance fluid rule in plain English
It ensures precise fluid administration for children, who are at high risk for both dehydration and fluid overload. A common mistake is applying a flat 'mL per kg' rate across the child's entire weight rather than using the tiered 4-2-1 logic.
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