Question

Background Information: Mary is a 12 month old who has been vomiting for the past 12...

Background Information:

Mary is a 12 month old who has been vomiting for the past 12 hours. Mary woke up at 5 AM but has not been able to “hold anything down”. Mary’s mother is concerned because it is now 4:00 pm. Mary’s mother calls the primary care office and is recommended by the nurse to have Mary evaluated at the clinic (Dr. Office). On initial assessment, Mary is lethargic and very quiet. She has mild nasal congestion and Her lips and skin are dry. She occasionally cries, but does not produce tears. Mary’s diaper has not been changed since 5 am and is currently dry upon this visitation to the clinic. Note: The season is late winter.

Information: During the insertion of a peripheral IV, Mary lies quietly throughout the procedure.

Questions:

  1. What concerns does the nurse have? Why?
  2. Why does the nurse need to repeat obtaining the weight when she just had one done in the office?
  3. What diagnostic tests are needed according to these findings?
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Answer #1

Ans. A. Nurse has concerns about hydration status of the Mary because the vomiting has led to fluid and electrolyte loss. Dryness of skin and lips,along with lethargic state and inactivity reflects the severe dehydration in Mary.

She is concerned about the replacement of the fluid and electrolytes loss and therefore immediately start the IV fluid therapy. Also urine output is also of concern. She will maintain intake & output and for that she will insert one per urethral catheter.

B. Fluid loss from the body will result in weight loss also therefore she needs to monitor the weight.

C. Diagnostic tests required are:-

1) Serum electrolytes

2) Kidney function test

3) Liver function test

4) USG whole abdomen

Hope it helps if it does then please upvote.

Thankyou!

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