Question

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An 13 month old child boy is admitted to your fluid with acute diarrhea secondary to shigella infection. He has had several days of watery, runny stools. There was a delay in placing his IV and he has not yet received any medications or fluids.

Diarrhea 1. What would you check to determine this patients level of dehydration? (ie: what are the signs of dehydration, what would you look for?)

Diarrhea 2. What labs and medications would you anticipate having ordered for this patient?

Answer 1

1.Assess for clinical signs and symptoms of dehydration, including thirst, weight loss, dry mucous membranes, sunken-appearing eyes, decreased skin turgor, increased capillary refill time, hypotension and postural hypotension, tachycardia, weak and thready peripheral pulses, flat neck veins when the patient is in the supine position, and oliguria.

2.Monitor and report abnormal lab results, including serum electrolytes, blood urea nitrogen (BUN), BUN/creatinine ratio, serum osmolality, and urine osmolality.

Antibiotics such as ciprofloxacin (common treatment for adults), and azithromycin (common treatment for children) are useful for severe cases of shigellosis