Child Dehydration
A 3-year-old child with viral gastroenteritis has had frequent watery stools and vomiting for two days and has refused oral fluids since last night.
Recognize cues
Vital signs: HR 162, RR 34, BP 78/46, temperature 38.4 C. The child is lethargic with sunken eyes, cries without tears, has dry mucous membranes, capillary refill of 4 seconds, and has had one wet diaper in 12 hours. Weight is down 9 percent from the clinic visit last week.
Which finding requires the most immediate follow-up?
Take action
The provider orders IV access, a 20 mL/kg isotonic fluid bolus, electrolytes, strict intake and output, and daily weights.
Which two actions should the nurse take first?
Evaluate outcomes
After fluid resuscitation: HR 118, BP 92/56, capillary refill less than 2 seconds, moist mucous membranes, the child is alert and playing, and has had three wet diapers in the last 6 hours.
Which finding best indicates the treatment is working?
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