3 - Paeds - Gastro - Gastroenteritis Flashcards Preview

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Flashcards in 3 - Paeds - Gastro - Gastroenteritis Deck (14):
1

commonest cause? what suggests bacterial cause? commonest bacterial cause? gives what symptom?

rotavirus
blood in stools
campylobacter jejuni - (bact less common) -ass w severe abdo pain

2

what happens? suggestive Hx points? what is most serious complication?

sudden change to water stools and vomiting
ate from a dodgy place/travel abroad
dehydration > shock - prevention/correction of this is main therapeutic goal

3

why are infants at higher risk of shock from dehydration

greater SA:W ratio so more insensible water losses, higher basal fluid req, immature renal tubular reabsorption and can't obtain fluids when wanted

4

5 RF's for worse disease course?

infants <6m/low birth wt
>6 diarrhoeal stools in last 24 h
>3 vomits in last 24 h
unable to tolerate extra fluids
malnutrition

5

how to assess hydration? 3 different bandings?

degree of wt loss during diarrhoeal illness
-no clinically detectable dehydration (<5% loss)
-clinical dehydration (5-10% loss)
-shock (>10% loss)

6

Iso/hyponatraemic dehydration...

inc intracellular vol > inc brain vol > convulsions

depleted EC vol > greater degree of shock per unit of water loss

7

hypernatraemic dehydration - Sx

jittery movement, inc muscle tone, hyperreflexia, convulsions, drowsiness, coma

8

What red flags signs help to identify children at risk of progression to shock..??

appears unwell/deteriorating
altered responsiveness
sunken eyes
tachycardia
tachypnoea
reduced skin turgor

9

Ix????

usually none
stool culture if septic,or blood/mucus in stool or immunocompromised or if ABx given

10

MGMT - no clinical dehydration?

prevention!
- continue BF +/or formula
- encourage fluids
- Oral rehydration solution (ORS) if at risk of further dehydration

11

MGMT - clinical dehydration

ORS - often and small amounts
fluid deficit replacement fluids -> 50ml/kg over 4h as well as maintenance fluid

inadequate intake/vomits persistently -> ORS via NG tube

12

MGMT - shock?

IV therapy - rapid infusion of 0.9% NaCl solution - repeat if needed
if remains shocked - consider PICU help

13

MGMT - clinical dehydration > deterioration/vomiting) OR if shock Sx/signs improve....do what?

IV therapy for rehydration
-replace deficit + maintenance fluids
-deficit = 10% of weight if shocked 5% if not shocked
-monitor plasma electrolytes, urea, creatinine, glucose
-consider IV K+ supplement
-continue BF if possible

14

MGMT - after rehydration therapy?

full strength milk + reintroduce usual solid food
avoid fruit juice + sodas
do not go back to child care/school for 48h after last episode

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