A 5-year-old child presents to Emergency Room with vomiting and diarrhea for 4 days. On examination, he looks dehydrated, hypoactive with sunken eyes, doughy skin and dry mucous me... A 5-year-old child presents to Emergency Room with vomiting and diarrhea for 4 days. On examination, he looks dehydrated, hypoactive with sunken eyes, doughy skin and dry mucous membrane. The capillary refill is 4 seconds. Blood pressure 90/70 mmHg, Heart rate 130/min, Respiratory rate 22/min, Temperature 36.6 °C, Oxygen saturation 95%. Which of the following is the expected serum sodium level based on clinical finding? A. Low B. High C. Normal D. No correlation
Understand the Problem
The question presents a clinical scenario of a 5-year-old child with dehydration symptoms. It asks to determine the expected serum sodium level based on these clinical findings. The key here is to recognize that dehydration can lead to varying sodium levels (hyponatremia, hypernatremia, or normonatremia) depending on the specific fluid and electrolyte losses.
Answer
The final answer is likely to be low or normal.
The expected serum sodium level is likely to be low (hyponatremia) or normal. Children with dehydration from vomiting and diarrhea can present with hyponatremia, hypernatremia, or normal sodium levels depending on the relative loss of water and sodium.
Answer for screen readers
The expected serum sodium level is likely to be low (hyponatremia) or normal. Children with dehydration from vomiting and diarrhea can present with hyponatremia, hypernatremia, or normal sodium levels depending on the relative loss of water and sodium.
More Information
The child's presentation suggests dehydration, as indicated by the sunken eyes, doughy skin, dry mucous membranes, prolonged capillary refill, and decreased blood pressure. While dehydration is present, the sodium level cannot be definitively determined from the clinical findings alone. Vomiting and diarrhea can cause either hyponatremia (low sodium), hypernatremia (high sodium) or normal sodium levels. Additional testing is needed to determine the serum sodium level.
Tips
A common mistake is to assume dehydration always leads to high sodium, but diarrhea can cause sodium loss.
Sources
- Question Sets and Answers - PMC - PubMed Central - pmc.ncbi.nlm.nih.gov
- A 5-year-old child has had severe vomiting and diarrhea for - MEDizzy - medizzy.com
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