Question

A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5 seconds. Which of the following would be most indicative of the need for intravenous rehydration therapy for this patient?

Answer 1

Based on the symptoms you have described, it appears that the 2-year-old is suffering from severe dehydration, most likely due to vomiting and diarrhea. If oral rehydration proves unsuccessful or if the child exhibits severe dehydration symptoms, intravenous (IV) rehydration therapy may be necessary.

Symptoms of severe dehydration include a parched mouth and throat, sunken eyes, inability to produce tears when crying, excessive sleepiness or drowsiness, irritability, skin that doesn't bounce back when pinched, and little to no urination for over 12 hours.

Furthermore, the high heart rate (152 beats/minute), increased respiratory rate (34 breaths/minute), and prolonged capillary refill time (>5 seconds) are worrying signs of severe dehydration that may require IV rehydration therapy.

Nevertheless, it's crucial to note that a healthcare professional should make the final call regarding treatment based on a thorough examination and assessment of the child's condition, including their hydration status and ability to tolerate oral fluids.