NR602 EXAM REVIEW AND FINAL GUIDE
Week 5
Gastrointestinal
Dehydration:
o A common problem, increased risk of diarrhea
o Infants and young children are at the highest risk
o Body fluids make up 75% of an infant’s bo
...
NR602 EXAM REVIEW AND FINAL GUIDE
Week 5
Gastrointestinal
Dehydration:
o A common problem, increased risk of diarrhea
o Infants and young children are at the highest risk
o Body fluids make up 75% of an infant’s body weight
o Infants/toddlers’ high ratio of surface area to weight equals more body loss through
evaporation
Diarrhea:
o Acute diarrhea is typically caused by viruses, like rotavirus, bacteria, and parasites
o Rotavirus is common in infants between 3 and 15 months of age
o Chronic diarrhea can be caused by antibiotic treatment of another condition, poor
absorption of starches and sugars, food allergies, laxative abuse in eating disorders,
hyperthyroidism, or irritable bowel syndrome
o In acute cases, treatment is supportive and includes fluid and electrolyte replacement
and/or antidiarrheals based on age; in chronic cases, treatment is specific to the
underlying conditions
Assessing dehydration:
o History of present illness (HPI): quantity and frequency of fluid intake, vomiting, and/or
diarrhea, urine output or number of wet diapers in 24 hours, duration or degree of fever,
types of medications, underlying diseases
o Weight is the most essential measure in calculating body fluid loss
o Physical exam (PE): vital signs, color, capillary refill, skin turgor, dryness of lips and
mucous membranes, lack of tears, sunken fontanelles, output, and mental status
Treatment of mild to moderate dehydration:
o Commercially available oral hydration solutions (ORS)
o Continue breastfeeding with ORS supplementation
o Offer young children 20 ml/kg per hour
o Offer older children 100 mL of ORS every 5 minutes
o Combine with IV therapy as needed
o Reassess after 4 hours; repeat if needed
o Avoid juice, soft drinks, and sports drinks
Treatment of severe dehydration:
o Evidence of compromised perfusion and severe dehydration
o Intravenous (IV) therapy of Ringer's lactate or normal saline if Ringers not available
o under 1 year, 30 ml/k
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