What are some dehydration warning signs and care tips for a child with diarrhea?

    Published: 06-16-2009
    Views: 11,896
    Robin Vick, Assistant Director of Nursing at the Continuum Pediatric Nursing Services, discusses the basic recommendations to help care for a sick child at home including some dehydration warning signs and care tips for a child with diarrhea.

    Host: What are some dehydration warning signs and care tips for a child with diarrhea?

    Robin Vick: Diarrhea is described as more than five loose or watery stools in a 12 hour period. So a parent to begin to see that the child's frequency of his/her stools going to mean that we have got to begin to worry about extra fluid losses that occur in diarrhea. We talk about fluid losses with a lot of concern because especially for kids who have very, very susceptible systems; small changes in fluid status can mean big changes inside them and parents need to be able to make the assessments of fluid status in this way. If you look at your child and you see dry lips, dry mucus membranes, the inside of their mouth. For an infant, if you see that their eyes are a little bit -- seem to be a little bit recessed. Children who are still infants have a soft spot in their head called a fontanel and that's right up here. For babies who are experiencing the risk for dehydration that fontanel is going to be little bit concaved, normally it's nice and flat. Also the child's, what I call skin turgor; a family can learn a lot by taking a little pinch of skin on the child's arm or chest and making a little pinch and watching as to how that skin falls back. In kids who have good fluid status the skin will fall back softly because there is lots of fluids up there in the subcutaneous tissue to keep that skin nice and tight and firm. In kids who are experiencing dehydration when a pinch is made like that the skin tends to tint. It stays upwards peaked a little bit and sometimes doesn't fall back flat against the body. Those are clinical signs that dehydration is definitely occurring; urine output, skin turgor, mucus membrane very important for parents to begin to assess. Don't worry that you don't know how to describe it, if you forget the work skin turgor, it doesn't matter. Just tell your doctor when I pull my child's skin; it's not as quick to release as it has been. In the first day it maybe hard for a child to even have the appetite for anything more than clear fluids as we talked about, but by the second day it's appropriate for a parent to begin to offer some dry food and for a child who can eat I would recommend rice cereal or boiled potatoes or a toast. For an infant again remember to make sure that you call your doctor for some guidelines. A baby who is being breast-fed, the rules about no milk products are different. The human maternal milk is never contraindicated; it's always a good thing for the baby. It's just cow's milk which usually upsets the stomach. I would like to also tell you little bit about things that are not good ideas to do for kids who are having diarrhea. A lot of these are very similar recommendations to what we talked about already when we were talking about vomiting and that is, not to use any over-the-counter products for your child unless they are ordered by the doctor. So in other words milk of magnesia, some things that are supposed to stop nausea; don't ever use those, even though they are out there for you to buy without a prescription unless your doctor or healthcare provider has said, it's time now or start this plan because they are not titrated and planned for the use by children. So always get the recommendations by your doctor for any over-the-counter medicine. Host: To watch the other segments in this video series or for how-to- videos on almost any other topic, visit www.