14299101
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
almost 6 years ago
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| Question | Answer |
| 1. List some of the factors you would consider when deciding whether to refer the infant or young child with gastroenteritis to hospital for admission. | • Severe dehydration • At risk of dehydration (age <6mths, high frequency of watery stools or vomits, minimal oral intake, worsening symptoms) • High risk of complications (diabetes, renal failure, poor nutrition) • Diagnosis in doubt or surgical diagnosis considered • Parent or carer unable to manage at home • Unsuccessful at oral rehydration |
| 2. TRUE/FALSE - viral gastroenteritis. a. When giving a fluid bolus, half normal saline (N/2) with 2.5% dextrose is an appropriate fluid to use. | False. Never give hypo-osmolar fluids as a bolus for resuscitation! This can precipitate dangerous levels of hyponatremia (and cause cerebral edema and irreversible brain damage, seizures and even death). Always use an isotonic fluid solution such as normal saline or Hartman’s solution. Recommended fluid is 0.9% saline + 5% dextrose (+ 20mml KCl if standard, no KCl if rapid). |
| 2. TRUE/FALSE - viral gastroenteritis. b. Nasogastric rehydration with an oral rehydration solution is as safe as (or safer than) and as effective as intravenous fluid in the treatment of gastroenteritis with moderate dehydration. | True. Nasogastric rehydration with ORS is as safe as (or safer than) and effective as intravenous fluid in the treatment of gastroenteritis with moderate dehydration. Ensure always that the tube is correctly placed in the stomach. Nasogastric rehydration is not appropriate for fluid resuscitation in a child who is in shock. Rapid IV/IO bolus of isotonic fluid is required for effective fluid resuscitation. |
| 2. TRUE/FALSE - viral gastroenteritis. c. Anti-motility agents are useful in decreasing diarrhoea in viral gastroenteritis. | False. Anti-motility drugs are not recommended in the treatment of viral gastroenteritis. They can prolong the illness and have potentially serious adverse effects especially in young children. |
| 2. TRUE/FALSE - viral gastroenteritis. d. Continued breast feeding is recommended throughout the illness. | True. Continued breast feeding is recommended throughout the illness. It is well tolerated and aids rehydration. |
| 2. TRUE/FALSE - viral gastroenteritis. e. Lactose free formula is recommended in children with acute gastroenteritis in the recovery phase. | False. Lactose free formula is not recommended in children with acute gastroenteritis. There is a place for temporary use of lactose free formula in children who have chronic diarrhea (of more than 14 days duration) after a viral gastroenteritis in whom you suspect secondary “transient” lactose intolerance. |
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