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8 Cards in this Set
- Front
- Back
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What further questions do you need to ask about child with vomiting for the last 3 days?
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Has he been around anyone else who has been ill?
Has he had significant abdominal pain? What is the character of the emesis (stomach contents, bilious, bloody?) What is the character of the stool (bloody, watery, mucus-containing)? Has he had fever? Is he eating and drinking? How much? Is he urinating? What is his level of activity? |
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Which aspects of the physical exam help you to determine the level of dehydration?
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Weight
Vital signs (heart rate, blood pressure) HEENT exam (fontanel, eyes sunken, mucous membranes) Skin turgor, temperature, character of perfusion Mental status/level of activity |
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Acute weight loss in this setting can be assumed to be primarily loss of water weight. Therefore:
Determining Degree of Dehydration? |
Weight loss (in grams) = water loss (in milliliters) or
Weight loss (in kg) = water loss (in liters) This result is usually converted to a "percent dehydration": Percent dehydration is the percent of total euvolemic body weight lost as water. |
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Oral rehydration therapy (ORT) using commercially prepared oral rehydration solutions (ORS) that contain glucose and electrolytes is used in cases of mild–moderate dehydration.
Benefits? |
ORT is as effective, safer, and much less costly than intravenous therapy.
ORT can be used effectively even when children are still having some vomiting. |
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Solid foods during dehydration or not dehydration?
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Children who have vomiting and diarrhea and are not dehydrated should continue to be fed age-appropriate diets.
Children who are dehydrated should be fed as soon as they have been rehydrated. Breastfeeding and formula feeding can continue through the period of rehydration. (This is especially important in lesser developed countries where malnutrition is an important contributing factor to morbidity and mortality associated with diarrhea and dehydration.) |
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Discharge instructions for mild-mod dehydrated children who received ORT, and have perked up:
When to come back? |
Return to clinic for the following:
Caleb again becomes listless He doesn't tolerate oral fluids and start to eat some solids The diarrhea doesn't resolve over the next couple of days. |
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In addition to purulent cervical discharge, what other physical finding is indicative of pelvic inflammatory disease (PID)? (Select the ONE best answer.)
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Cervical motion tenderness
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Regarding treating PID:
Which of the following would be reasons to hospitalize Mandy? Select all that apply. |
Pregnancy
High probability of noncompliance High fever or intractable vomiting DInability to exclude a surgical emergency NOTE: HIV IS NOT AN INDICATION FOR HOSPITALIZATION |
