Question

Rehydration Plan: ( for pediatrics!)

includes:

signs and symptoms,

appropriate rehydration therapy,

replacement of stool losses,

maintenance therapy for each of the three degrees of dehydration.

Answer 1

Rehydration plan for pediatrics is a treatment plan for replacing the fluid loss in the paediatric cases.

Signs and Symptoms :

• Thirst increases ,forms the first sign
• A dark coloured urine due to less fluid in the body or a concentrated urine
• Weak or lethargic
• Dry skin,lips,mouth
• Drowsy or dizziness
• Cool skin
• Irritable
• Sunken fontanell (soft spot) is sunken
• Sunken eyes
• No tears

Appropriate rehydration therapy

The mild to moderate dehydration are usually treated with Oral rehydration solution (ORS)

Repeated abd demand Breast feeding for newborns

Frequent fluid sips for kids

Nasogastric fliud replacement if child refuses to take

Intravenous fluid replacement when there is excess fluid loss or child is unconscious

Sodium concentration has to be assesed before administering

Home fluids can be encouraged

Limit ORT in coma patients,intestinal obstructions or bowel diseases or in severe dehydration

Lactated Ringer is the preferred solution

Normal saline,Half NS ,Half Darrow's solution are acceptable solutions

Replacement of fluid losses

If the child has dehydration because of diarrhoea The major loss is water and sodium which are replaced by the ORS

Maintainace therapy

• Mild dehydration: Oral rehydration therapy,Increase home fluids,frequent sips of water (50ml/kg over 4hours)
• Moderate dehydration :ORT,(100ml/kg over 4 hours)
• Severe dehydration:Intravenous therapy (20-40ml /kg of isotonic fluid in 15 to 60 minutes

In oral rehydration therapy 100ml/kg for 10 kg,1000ml+ 50 ml for 11 to 20 kg,1500ml+20ml for each kg over 20kg

Phase 1 is over first one hour,phase 2 is about 8 hour and phase 3 is after 8 hours in the fluid administration