Gastroenteritis assessment Flashcards
A 2 year old child, Kate, comes to see you after three days of copious vomiting and diarrhoea. You last saw her a week ago when she had a minor cold. You want to assess her level of dehydration.
What is the best objective indicator of Kate’s degree of dehydration?
Question 1Select one:
a.
Delayed peripheral and central capillary refill
b.
Drop in body weight over the last three days
c.
Not passing wet nappies as much as usual
d.
Decrease in skin turgor over abdominal wall
Drop in body weight over the last three days
objective
Katie, aged 3 years old, presents with acute gastroenteritis of 2 days duration. She has lost 10% of her body weight in the last 3 days. She also has decreased capillary refill and tachycardia (heart rate 150 beats/min). She has decreased tissue turgor and her lips and tongue look dry.
What is the most appropriate first step in treating Katie’s gastroenteritis?
Question 2Select one:
a.
Take a more thorough history including travel
b.
Give immediate IV solution bolus 10ml/kg weight
c.
Start oral rehydration fluids 10 ml every minute
d.
Take blood for renal function and electrolytes
Give immediate IV solution bolus 10ml/kg weight
Need to fix circulation
Sally is a 2 year old who has had diarrhoea and vomiting for 2 days. She is thirsty and urine may be a little concentrated, but and a 2% drop in body weight from when she saw the GP last week. She has normal heart rate, skin turgor and capillary refill.
What is the most appropriate way to manage her dehydration?
Question 3Select one:
a.
Take bloods to check full blood count, urea and electrolytes
b.
Place an IV line and give a bolus of 10 ml/kg normal saline
c.
Give oral rehydration solution 1ml/kg/each 5 min for 1 hour
d.
Start nasogastric rehydration at 5 ml/kg/hour for 6 hours
Give oral rehydration solution 1ml/kg/each 5 min for 1 hour
Allows GI tract to manage electrolytes. NGT only if refusing oral
Alana, aged 3, has been having copious diarrhoea and some vomiting for 3 days. Her mother has given her as much fruit juice and lemonade as much as she will take. However, the diarrhoea seems to be getting worsen and Alana is becoming lethargic and irritable when disturbed.
What type of dehydration is Alana at risk from in this situation, taking into account Alana’s illness and her treatment?
Question 4Select one:
a.
Hyperglycaemic
b.
Hypernatraemic
c.
Iso-natraemic
d.
Hyponatraemic
Hypernatraemic
sugar drinks, gut can’t absorb all sugar - osmotic draws water in
An 18-month old boy with acute gastroenteritis is found to have hypernatraemic dehydration with a serum sodium of 160mmol/L. He was initially rehydrated at home. You wonder if the hypernatraemia is due to the form of rehydration he has been given.
What is the component of rehydration fluids that, at high concentration, are most commonly responsible for hypernatraemia like this?
Question 5Select one:
a.
Sodium
b.
Potassium
c.
Sugar
d.
Lactate
Sugar
should dilute to 1/3 normal
A 12-month-old baby, Marcus, weighing 10 kg is brought to your surgery after 24 hours of copious diarrhoea. On examination, the child is afebrile and alert, and the vital signs are normal. The anterior fontanelle is slightly depressed, the oral mucosa is dry and skin turgor is decreased. There is no other abnormality. What is the approximate fluid deficit of this child?
Question 6Select one:
a.
1500-1900 ml
b.
5000-9000 ml
c.
500-900 ml
d.
50-90 ml
500-900 ml
moderate dehydration shown by skin signs. = 5-9% dehydration
