PSYCH 2AP3 Lecture Notes - Lecture 15: Tachycardia, Blood Culture, Fluid Balance
13 Aug 2020
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Inspection: concious level, general appearance, skin colour, eyes. Examination: mucous membrane, skin turgor, cap refill, warmth of extremities, peripheral pulses. Observations: bp, hr, rr, urine output. Oral fluid challenge: child drinks 60ml of ors over 2 hours and vomits most of it on the floor. Put urine bag on child: child produces no urine in 2 hours. Bloods: fbc, u&es , urea, creatinine. Stool culture? (not indicated as likely rotavirus) Blood culture? (not indicated as does not appear to be septic) Moderate dehydration (clinical dehydration) 5-10% weight loss. Continue breast milk and other milk feeds (even during period of active rehydration) Reintroduce other feeds after initial 4 hour correction period of deficit. Set up fluid balance chart: urine, vomit and stools (measure mass of nappies/ urine bag on child) Rehydration: fluid requirement for 24 hours = maintenance + correction of deficit. 100mlkg for first 10kg of body weight.
