Assessment of a patient with diarrhoea

The assessment of dehydration is most important. Dehydration is due to an insufficient intake of liquids (drinking, IV fluid) and/or excessive loss of fluid (vomiting, diarrhoea, polyuria, sweating). If loss of gastro-intestinal fluid is the cause, the patient will urinate less (oliguria) in order to minimise the loss.

If a child has lost <>

If 5-10% of body weight is lost the eyes are sunken, the fontanelle is hollow, the skin is no longer elastic, the lips and mouth are dry and sometimes cracked. The child is miserable, restless and cries. There are no tears. Breathing becomes more rapid (acidosis). This must be distinguished from an accompanying pulmonary infection. Urine production decreases. The fluid deficit is 50-100 ml/kg.

With a fluid loss of >10% the child is still and cold. The pulse is rapid and difficult to feel (circulatory collapse). Skin folds do not disappear, the mucous membranes are very dry, the abdomen is hollow, the eyes are deeply set and the fontanelle is deeply sunken. Usually there is no more urine. The fluid deficit is >100 ml/kg.

Category: Medical Subject Notes , Medicine Notes