Ped q - ani71

[ArchivalUser]

5. A previously healthy 20-month-old is brought to the ED bc of vomiting and diarrhea for 5 days. Her stools have been streaked with blood and mucus. Her oral intake and urine output have decreased during this period. She appears lethargic. Her temp is 100.4 BP is 60/40 pulse is 150 and respt are 40. Exam shows dry mucus mmbs. The remainder of the exam shows no abnormalities. Cap refill is 4 sex. Lab shows Hct 39%, WBC 6500, platelet 200,000, Na 131, cl 94, K 3.6, HCO3 12, BUN 45 Cr 1.5. Most appropriate next step is:
A) SubQ epi,
B) IV corticosteroids,
C) IVIG,
D) IV sodium Bicarb,
E) IV NS,
F) Transfuse PRBCs.
Answer: D?

[ArchivalUser]

It looks like this poor baby is dehydrated. Therefore, i believe the smartest thing to do is E(IV normal saline)

[ArchivalUser]

yup i agree first NS .

[ArchivalUser]

E)IV NS

[ArchivalUser]

it shd be normal saline why r u thinking D there is no acidosis

[ArchivalUser]

shailaja why do you think there is no acidosis?