A child has diarrhea 7 times and he is irritable and has lost his skin turgor.

الشرح

Core Concept: Dehydration in children is classified based on clinical signs and estimated fluid loss. Irritability, lost skin turgor (skin pinch goes back slowly), sunken eyes, and frequent diarrhea are classic signs of moderate dehydration, which typically represents a 5% to 10% fluid deficit in infants/children.

Clinical Presentation:

• Symptoms: Irritability, sunken eyes, delayed capillary refill, decreased tears, dry mucous membranes, and lost skin turgor.
• Complications: Hypovolemic shock, acute kidney injury, and severe metabolic acidosis.

Diagnosis:

• First-line: Clinical dehydration scale (e.g., WHO classification or Clinical Dehydration Scale).
• Gold Standard: Serum electrolytes, BUN/creatinine, and blood gas to assess for acidosis and ion imbalances.

Management:

• Acute: Oral rehydration therapy (ORT) with low-osmolarity ORS (50-100 ml/kg over 4 hours) if the child can drink; otherwise, IV fluids (Normal Saline or Ringer's Lactate).
• Definitive: Zinc supplementation, continued breastfeeding/feeding, and close monitoring of fluid balance and urine output.