In correcting dehydration and replacing fluid losses, what is the estimated initial bolus and the rate for replacing the rest of the deficit?

• A. 10 ml per pound as the initial bolus; rest replaced at 2-5 ml per pound over 12-24 hours
• B. 20 ml per pound bolus; rest over 6-12 hours
• C. 5 ml per pound bolus; rest over 48-72 hours
• D. 15 ml per pound bolus; rest over 24 hours

Answer: (A)

The key idea is to restore blood volume quickly but safely by using a staged approach: first give a modest rapid bolus to improve perfusion, then replace the remaining deficit gradually over the next day to avoid fluid overload. An initial bolus of about 10 mL per kilogram of isotonic crystalloid is enough to lift intravascular volume in many dehydration cases, providing a quick nudge to perfusion without overshooting. After that, the rest of the deficit is repleted over 12 to 24 hours at a rate of about 2–5 mL per kilogram, allowing continued monitoring and adjustment while preventing rapid shifts that could harm tissues. Maintenance fluids and any ongoing losses are added on top as you reassess.