A 5 year-old child presents to the Emergency Room with vomiting and diarrhea for 4 days. On examination, he looks dehydrated and inactive with sunken eyes, doughy skin and dry muco... A 5 year-old child presents to the Emergency Room with vomiting and diarrhea for 4 days. On examination, he looks dehydrated and inactive with sunken eyes, doughy skin and dry mucous membrane. The capillary refill is slow. Blood pressure is 90/70 mmHg, heart rate is 130/min, respiratory rate is 22/min, temperature is 36.6 degrees C, and oxygen saturation is 95%. Which of the following is the expected serum sodium level based on clinical finding: Low, High, Normal, or No correlation?
Understand the Problem
The question is asking us to determine the expected serum sodium level of a 5-year-old child presenting with dehydration symptoms. The child has been vomiting and experiencing diarrhea for 4 days, and the physical examination reveals signs of dehydration (sunken eyes, doughy skin, dry mucous membrane). We must interpret these clinical findings to predict whether the child's serum sodium level is likely low, high, normal, or uncorrelated.
Answer
No correlation
In a child presenting with dehydration due to vomiting and diarrhea, the serum sodium level can be low, normal, or high depending on the type of dehydration (hypotonic, isotonic, or hypertonic, respectively). However, given the clinical signs of dehydration (sunken eyes, doughy skin, dry mucous membranes, slow capillary refill) along with borderline low blood pressure and increased heart rate, it is difficult to predict the serum sodium level without additional lab results. Therefore, the best answer is No correlation.
Answer for screen readers
In a child presenting with dehydration due to vomiting and diarrhea, the serum sodium level can be low, normal, or high depending on the type of dehydration (hypotonic, isotonic, or hypertonic, respectively). However, given the clinical signs of dehydration (sunken eyes, doughy skin, dry mucous membranes, slow capillary refill) along with borderline low blood pressure and increased heart rate, it is difficult to predict the serum sodium level without additional lab results. Therefore, the best answer is No correlation.
More Information
Serum sodium levels in dehydrated patients can be low (hyponatremic), normal (isonatremic) or high (hypernatremic). It is hard to predict the serum sodium level without additional lab results.
Tips
The serum sodium level cannot be determined based on the clinical finding. The type of dehydration must be determined before knowing the serum sodium level
Sources
- Pediatric Dehydration - StatPearls - NCBI Bookshelf - ncbi.nlm.nih.gov
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