Question

1- Define and describe the three types of dehydration and potential causes.

2- Differentiate between mild, moderate, and severe dehydration.

3- What are different treatment for each type of dehydration based on the CDC guidelines and Up to date?

4- Identify and demonstrate teaching strategies with the parent and child. ( be familiar with oral rehydration and diets for children with fluid and electrolyte imbalances.

5- Who is primarily effected with Rotavirus. What are the signs and symptoms of Rotavirus? How is Rotavirus transmitted? What is the the treatment of Rotavirus?

Answer 1

1- Define and describe the three types of dehydration and potential causes.

Answer:

Dehydration occurs when you lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions.

Three type of dehydration is as below,

1. Isotonic water loss occurs when water and sodium are lost together. Causes of isotonic water loss are vomiting, diarrhea, sweating, burns, intrinsic kidney disease, hyperglycemia, and hypoaldosteronism.
2. Hypertonic dehydration occurs when water losses exceed sodium losses. Serum sodium and osmolality will always be elevated in hypertonic dehydration. Excess pure water loss occurs through the skin, lungs, and kidneys. Etiologies are fever, increased respiration, and diabetes insipidus.
3. Hypotonic dehydration is mostly caused by diuretics, which cause more sodium loss than water loss. Hypotonic dehydration is characterized by low sodium and osmolality.

Body water is lost through the skin, lungs, kidneys, and GI tract. The loss of body water without sodium causes dehydration.

• Water is lost from the skin, lungs, gastrointestinal tract, and kidneys.
• Dehydration results when water losses from the body exceed water replacement.
• It may be caused by failure to replace obligate water losses.

2- Differentiate between mild, moderate, and severe dehydration.

Answer:

Mild Dehydration	Moderate Dehydration	Severe Dehydration
flushed face thirst dry, warm skin cannot pass urine or reduced amounts, dark, yellow coloring light shade of yellow urine weakness cramping in arms and legs unwell headaches dry mouth/lips, dry tongue; with thick saliva lightheadedness, worse when standing irritable or sleepy crying with no or few tears (mainly in children)	low BP (postural hypotension[10]) headaches[10] darker shade of yellow urine fainting severe muscle contractions in arms, legs, stomach, and back convulsions bloated stomach heart failure sunken fontanelle (soft spot on infant's head) sunken dry eyes skin loses firmness and looks wrinkled lack of elasticity of skin rapid and deep breathing fast, weak pulse	decline consciousness increased heart rate (radial pulse may be undetectable) decreased or low blood pressure effects are more pronounced peripheral cyanosis confusion, lethargy, irritability[10] cold hands and feet[10] unable to urinate[10] hypovolaemic shock effects are more pronounced death may occur, if rehydration is not started quickly

3- What are different treatment for each type of dehydration based on the CDC guidelines and Up to date?

Answer:

The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes.

Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water.

Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Diarrhea may be worsened by full-strength fruit juice and soft drinks.

If you work or exercise outdoors during hot or humid weather, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful.

Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room. Salts and fluids delivered through a vein (intravenously) are absorbed quickly and speed recovery.

4- Identify and demonstrate teaching strategies with the parent and child. ( be familiar with oral rehydration and diets for children with fluid and electrolyte imbalances.

Answer:

For mild dehydration, 50 mL per kg of ORT solution should be administered over four hours using a spoon, syringe, or medicine cup; this can be accomplished by giving 1 mL per kg of the solution to the child every five minutes. Patients may be treated at home. If the child vomits, treatment should be resumed after 30 minutes.  After the four-hour treatment period, maintenance fluids should be given and ongoing losses assessed and replaced every two hours. Maintenance therapy includes providing anticipated water and electrolyte needs for the next 24 hours in the child who is now euvolemic with expected normal urine output. Based on average weights of infants and children, this method can be further simplified to provide maintenance ORT at home: 1 oz per hour for infants, 2 oz per hour for toddlers, and 3 oz per hour for older children. To replace ongoing losses, 10 mL per kg for every loose stool and 2 mL per kg for every episode of emesis should be administered.

For moderate dehydration, 100 mL per kg of ORT solution should be given over four hours in the physician's office or emergency department. If treatment is successful and ongoing losses are not excessive, the child may be sent home. At home, caregivers should provide maintenance therapy and replace ongoing losses every two hours as described for mild dehydration. ORT is considered to be unsuccessful if vomiting is severe and persistent (i.e., at least 25 percent of the hourly oral requirement) or if ORT cannot keep up with the volume of stool losses.

Severe dehydration should be treated with intravenous fluids until the patient is stabilized (i.e., circulating blood volume is restored). Treatment should include 20 mL per kg of isotonic crystalloid (normal saline or lactated Ringer solution) over 10 to 15 minutes. No other fluid type is currently recommended for volume resuscitation in children.26 Treatment should be repeated as necessary, with monitoring of the patient's pulse strength, capillary refill time, mental status, and urine output. Stabilization often requires up to 60 mL per kg of fluid within an hour. Electrolyte measurement should be performed in all children with severe dehydration and considered in those with moderate dehydration because it may be difficult to predict which children have significant electrolyte abnormalities. After resuscitation is completed and normal electrolyte levels are achieved, the patient should receive 100 mL per kg of ORT solution over four hours, then maintenance fluid and replacement of ongoing losses. If ORT fails after initial resuscitation of a child with severe dehydration, intravenous fluid therapy should be initiated. First, 100 mL per kg of isotonic crystalloid should be administered over four hours, followed by a maintenance solution. This method also may be used when a child with moderate dehydration fails ORT.

5- Who is primarily effected with Rotavirus. What are the signs and symptoms of Rotavirus? How is Rotavirus transmitted? What is the the treatment of Rotavirus?

Answer:

Rotavirus infections are common in children ages 3 to 35 months — particularly those who spend time in child care settings. Older adults and adults caring for young children have an increased risk of infection as well. In the United States, the risk of rotavirus is highest in winter and spring.

The most common symptoms of rotavirus are severe watery diarrhea, vomiting, fever, and/or abdominal pain.

Symptoms usually start about 2 days after a person is exposed to rotavirus. Vomiting and watery diarrhea can last 3 to 8 days. Additional symptoms may include loss of appetite and dehydration (loss of body fluids), which can be especially dangerous for infants and young children.

Symptoms of dehydration include:

• decreased urination
• dry mouth and throat
• feeling dizzy when standing up
• crying with few or no tears and
• unusual sleepiness or fussiness.

You can get infected with rotavirus if you get rotavirus particles in your mouth. People who are infected with rotavirus shed the virus in their stool (poop). This is how the virus gets into the environment and can infect other people.

There is no specific medicine to treat rotavirus infection, but your doctor may recommend medicine to treat the symptoms. Antibiotics will not help because they fight bacteria not viruses.

Since rotavirus disease can cause severe vomiting and diarrhea, it can lead to dehydration (loss of body fluids). The best way to protect against dehydration is to drink plenty of liquids. Oral rehydration solutions are most helpful for mild dehydration. Severe dehydration may require hospitalization for treatment with intravenous (IV) fluids. Infants and young children, older adults, and people with other illnesses are most at risk of dehydration.