Question

A mother brings her 8-month-old infant, Mary, to the primary care clinic. The mother reports that Mary has had a “cold” for about 2 days, and this morning she began to vomit and has had diarrhea for the past 8 hours. The mother states that Mary is still breastfeeding, but she is not taking as much fluid as usual and she is having three times as many stools as usual (the stools are watery in consistency). When the nurse practitioner examines Mary, she notes that her temperature is 38° C (100.4° F), her pulse and blood pressure are in the normal range, her mucous membranes are moist, and she has tears when she cries. The nurse practitioner also notes that Mary's weight has not changed from what it was when she was seen in the clinic 2 weeks ago for her well-child visit.

1. Evidence—Is there sufficient evidence for the nurse and nurse practitioner to draw any conclusions for her initial plan of management?

2. Assumptions—Describe some underlying assumptions about the following:

a. Clinical manifestations of various levels of dehydration

b. Management of acute diarrhea

c. Breastfeeding and the management of acute diarrhea

d. Use of antidiarrheal medications for acute diarrhea

3. Which nursing interventions should the nurse and nurse practitioner implement at this time?

4. Does the evidence support the nurse and nurse practitioner's conclusion?

Answer 1

1) yes, evidence are sufficient enough for initial management like baby is having cold , vomiting diarrhoea, so initial management can be done by giving ors solution because it doesn't have side-effects. While drugs can have..

2)clinical manifestation of various level of dehydration

Dry mouth , lips and eyes, feeling tired, feeling thirsty, dark yellow pee, nausea, vomiting, etc

Management of acute diarrhoea - child ors solution, administer zinc dispersible tablet,  

Breastfeeding and management of acute diarrhoea -  - continue breastfeeding and ors and other electrolyte solution given between breastfeeding for 6-24 hours

Use of antidiarhoeal drugs for acute diarrhoea - drugs are less often used mainly ors solution is given but drugs like loperamide and azithromycin is used

3) nursing intervention

Give IV fluids, water and fruit juices, medication ( acetaminophen, children's Tylenol)  

4) there are evidence, only water, fruit juices are given if children is above 6 months old, and only Tylenol is given. If other medication are given then it will cause harmful effects