Pediatric Gastroenteritis SKINNY Reasoning : Harper Anderson, 5 months old
1. The patient has a decreased LOC. She is lethargic, irritable, and produces
... [Show More] no tears. This indicates that the child is dehydrated. Lack of production of tears shows that the child cannot produce fluid due to not having enough fluid volume within her body. Being lethargic and irritable could be a sign of electrolyte imbalance due to her diarrhea and vomiting. Her balance of electrolytes like potassium and sodium could be decreased. If the child is hypokalemic, potassium should be elevated quickly to prevent cardiac dysrhythmias. If the child has hyponatremia, it can could cause lethargy.
2. Her skin is pale, cool, and has a delayed capillary refill. These are all signs of a decreased blood volume circulating to the extremities. Because her blood volume is diminished in her extremities, this could mean that her body is going into shock due to her high HR and respiration rate. If her body is in shock, her blood would be shunted, which would explain the diminished capillary refill, coolness, and pallor in the distal extremities.
3. Lethargy and lack of eye contact with her loved one is a
concerning sign of dehydration. This is due to a decreased LOC which is seen as the child will not make eye contact with her mother. Eye contact is sign of a healthy child since it would indicate growth and development. However, because the child will not make eye contact and is fatigued, the child’s body is severely fighting off dehydration or decreased fluid volume.
4. Hyperactivity of the abdomen is an abnormal finding because it
signifies increased gastrointestinal activity. The child is 5 months and should have seen started eating minimal solid foods only recently. It is abnormal for the child to be hyperactive as food has barely been introduced. An absence of tenderness upon palpation is also abnormal since GI activity is elevated. Tenderness when palpated is typically a sign of a gastrointestinal issue with a short onset. However because no tenderness is felt, it can indicate a more serious problem for the child as a long-term medical issue at this age is serious and could lead to more detrimental issues.
5. Urine being dark amber and cloudy is abnormal. This can indicate an infection within the urinary system as cloudiness indicates white blood cells being detected within the urine. 5 mL of urine is extremely little as the child should be producing about 1-3 mL per hour. A decrease in urine can indicate a functional issue with the kidneys as the organs are not producing enough urine. Dark amber color indicates there is a high concentration but lack of output. [Show Less]