Question

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect:
Select one:
A. moderate dehydration.
B. mild dehydration.
C. severe dehydration.
D. hypovolemic shock.

Answer 1

Answer:

The best answer to the question: You should suspect:___, would be, A: moderate dehydration.

Explanation:

This is a 6-month old baby who has been with diarrhea and vomiting for two days. He presents a lessened level of activity, a heart rate of 140 bpm and whose anterior fontanelle appears shrunken due to the loss of water and electrolytes. However, there are also good news: the baby has not had either emesis, or diarrheic episodes for at least 12 hours.

Taking these symptoms into consideration we can say that the child has moderate, and not severe dehydration, or even worse, hypovolemic shock, because his heart rate, which would be one of the most clear indications of severe dehydration, is still within the normal ranges for a child of that age (80 to 160 bpm for children between 2 and 11 months). Also, the child has reduced levels of activity, but there is still presence of activity and he is still concious. Finally, the fontanelle´s situation, although worrisome, is indicative that the volumes in the child are low, but can be brought back up easily enough since he has not presented another episode in 12 hours.