Editing Pediatric Nursing (section)

=== Gastroenteritis and dehydration ===

Dehydration is graded by weight loss and clinical signs. Early findings include decreased urine output, dry mucous membranes, and absence of tears. Later findings are sunken eyes and fontanel, poor skin turgor, tachycardia, and lethargy. '''Weight change is the most accurate measure of fluid loss in children.'''

* '''Oral rehydration solution is first-line for mild to moderate dehydration''', given in small frequent volumes. Plain water, juice, soda, and sports drinks are inappropriate because of inadequate or unbalanced electrolyte content.
* Severe dehydration or shock is treated with a '''20 mL/kg bolus of isotonic crystalloid''' (0.9 percent sodium chloride or lactated Ringer's), which may be repeated with reassessment after each bolus.
* Rotavirus vaccine has substantially reduced severe infantile gastroenteritis.
* Contact precautions apply; alcohol-based hand rub is not reliable against norovirus or ''Clostridioides difficile'', so use soap and water.