02-28-2008, 12:04 PM
A 3-year-old boy is brought to the emergency department by his mother because he is lethargic and refuses to eat. His family recently arrived in the US as refugees from an African country. His mother hardly speaks English, and this has made history-taking very challenging. His temperature is 36.1C(97F), blood pressure is 90/60 mm Hg, pulse is 130/min, and respirations are 26/min. His height corresponds to the 38th percentile and his weight to the 5th percentile. He is lethargic and hypoactive. There is symmetrical edema of both feet. Painful, oral ulcers are observed. The patient is subsequently admitted to the hospital for rehydration and feeding. Which of the following is the best statement concerning the initial management of this patient?
A. Establish IV line and start IV hydration/feeding
B. Insert nasogastric tube and start hydration/feeding
C. Start high-calorie feeding
D. Start high-protein feeding
E. Start iron supplementation
A. Establish IV line and start IV hydration/feeding
B. Insert nasogastric tube and start hydration/feeding
C. Start high-calorie feeding
D. Start high-protein feeding
E. Start iron supplementation