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Old 08-09-2012
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Kids How to manage child with gastroenteritis and dehydration?

A mother brings her 7-year-old son to an emergency clinic because he has been vomiting and has had diarrhea for the past 3 days. Upon taking a history, the attending physician determines that the emesis was nonbilious and nonbloody, and the diarrhea was nonbloody, loose, and watery. The patient states that he vomited more than ten times, and the number of times for his diarrhea are too numerous to count. He is in the second grade, and has had no ill contacts and no recent travel. There is no exposure to pets. On clinical examination, the physician determines that the patient is dehydrated with a loss of less than 5% of his total body water (TBW). Which of the following choices represents the next best step in management of this patient?

(A) Give the patient a bolus of 20 mL/kg of isotonic crystalloid over 20 minutes.
(B) Give the patient no less than 60 mL/kg of isotonic crystalloid to restore perfusion.
(C) Give the patient maintenance fluids of 5% dextrose and 0.45 N saline to replace the fluid deficit and to accommodate ongoing losses.
(D) Give the patient an antiemetic.
(E) Give the patient an antibiotic to treat the infectious process.

expln the ans.

***what can be said of volume status of kid...mild,mod,severe dehydration ?
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Old 08-09-2012
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3-5% volume loss is mild dehydration.....

and the ans is A......

only isotonic crystalloid solutions be given to children for volume resuscitation ans since its mild dehydration ,only 20ml/kg is sufficient ......
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Originally Posted by K06100 View Post
3-5% volume loss is mild dehydration.....

and the ans is A......

only isotonic crystalloid solutions be given to children for volume resuscitation ans since its mild dehydration ,only 20ml/kg is sufficient ......
thats correct. not mentioned in options though, but for mild dehydration we can just give ORS. right ?

what is mx for mod and severe dehydration ?

one thing more, is there an easy way to tell kid is mild, mod, severe dehydrated if % dehydration not given...
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Old 08-09-2012
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Originally Posted by tyagee View Post
thats correct. not mentioned in options though, but for mild dehydration we can just give ORS. right ?

what is mx for mod and severe dehydration ?

one thing more, is there an easy way to tell kid is mild, mod, severe dehydrated if % dehydration not given...
They would need to give you clinical signs
For example:
Mild to moderate dehydration is likely to cause:
  • Dry, sticky mouth
  • Sleepiness or tiredness children are likely to be less active than usual
  • Thirst
  • Decreased urine output no wet diapers for three hours for infants and eight hours or more without urination for older children and teens
  • Few or no tears when
Severe dehydration
  • Extreme thirst
  • Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
  • Very dry mouth, skin and mucous membranes
  • Lack of sweating
  • Little or no urination any urine that is produced will be dark yellow or amber
  • Sunken eyes
  • Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold
  • In infants, sunken fontanels the soft spots on the top of a baby's head
  • Low blood pressure
  • Rapid heartbeat
  • Rapid breathing
  • No tears when crying
  • Fever
  • In the most serious cases, delirium or unconsciousness
  • crying
  • Dry skin


Think of severe dehydration like the beginnings of hypovolemic shock
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I was just typing ....but XpaezX showed great smartness......
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Last edited by K06100; 08-09-2012 at 03:26 PM.
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