Question Of The Day: Preschooler

Q. A dehydrated 3 year old has vomited three times in the last hour and continues to have frequent diarrhea. The child was admitted 2 days ago with gastroenteritis caused by rotavirus. The child weighs 22 kg, has a normal saline lock in the right hand, and has had 30 ml of urine output in the last 4 hours. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the primary healthcare provider with a recommendation for:

A. Giving a dose of loperaminde (Immodium).
B. Starting a fluid bolus of normal saline.
C. Beginning an intravenous (IV) antibiotic.
D. Establishing a Foley catheter.

Correct Answer: B

Explanation: The child is dehydrated, cannot retain oral fluids, and continues to have diarrhea. A normal saline bolus should be given followed by maintenance IV fluids. Anti-diarrheal medications are not recommended for children and will prolong the illness. The child has gastroenteritis caused by a viral illness. IV antibiotics are not indicated for viral illnesses.