rehydration and replacement of losses is a priority. Assessment of the degree of dehydration is basic to determining a treatment plan. One study which performed a systemic review of the literature evaluated the diagnostic accuracy of the Clinical Dehydration Scale (CDS), the World Health Organization (WHO) scale, and the Gorelick scale for children from 1 month to 5 years of age [ CITATION Fal17 \l 1033 ]. They concluded that the CDS scale was of limited value in ruling in severe dehydration and the other two have not been studied adequately to determine their accuracy. The CDC recommends using symptoms on assessment to determine the degree of dehydration: mental status, thirst, heart rate and quality of pulses, breathing, eyes, tears, mucous membranes, skin turgor, capillary refill and urine output [ CITATION Man19 \l 1033 ]. Minimal or no dehydration is < 3% loss of body weight, mild to moderate is 3-9% loss of body weight, and severe is with >9% loss of body weight. Oral fluid replacement should be used for minimal to moderate dehydration as long as the child is able to take oral fluids. IV fluids should only be used when the child cannot take po and dehydration is severe [ CITATION Bur17 \l 1033 ]. References Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C., Garzon, D., & Gaylord, N. (2017). Pediatric Primary Care, 6th edition. St. Louis, MO: Elsevier, Inc. Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2017). Primary Care: A Collaborative Practice, 5th Edition. St, Louis, MO: Elsevier. Cash, J. C., & Glass, C. A. (2017). Family Practice Guidelines, 4th edition. New York, NY: Springer Publishing Company. Chiocca, E. (2015). Advanced Pediatric Assessment, 2nd edition. New York, NY: Springer Publishing Company. Crohn's & Colitis Foundation. (2019). Just Like Me IBD . Retrieved from
Falszewska, A., Dziechciarz, P., & Szajewska, H. (2017). Diagnostic accuracy of clinical dehydration scales in children. European Journal of Pediatrics, 176 (8), 1021-1026. doi: Goolsby, M. J., & Grubbs, L. (2015). Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses, 3rd edition. Philadelphia, PA: F.A. Davis Company. Hay, W., Levin, M., Deterding, R., & Abzug, M. (2016). Current Diagnosis & Treatment: Pediatrics, 23rd edition. New York, NY: McGraw-Hill Education. Inflammatory Bowel Disease . (2019). Retrieved from GIKids: Management of Acute Diarrhea . (2019, January 29). Retrieved from CDC: Centers for Disease Control and Prevention: Murphy, M. (2008). Management of bloody diarrhorea in children in primary care. BMJ (Clinical research ed.), 336 (7651), 1010-1015. doi: DQ POST – posted 8/17/19 Which essential questions will you ask a pediatric patient or his or her caregiver when the presenting complaint is bloody diarrhea? Will these questions vary depending upon the child’s age? Why or why not?
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- Gastroenterology, Ulcerative colitis, Inflammatory bowel disease, Crohn's disease