Extracellular fluid volume deficit related to invasion of the stomach and intestine by a virus manifested by nausea and vomiting STG: Child will return to normal hydration status as evidenced by moist mucus membranes by discharge.

LTG: Child will be free from vomiting and regain weight lost during the illness within two weeks of being free from illness by tolerating a regular diet. 1. Teach care providers to practice proper hand washing.

2. Check identification bands are correct and intact q. shift

3. Assess vital signs q.4hrs

4. Assess child’s hydration by assessing mucus membranes and skin turgor and capillary refill q.4hrs

5. Monitor and record I & O q. hr

6. Administer IV fluid D5 1/4NS @ 40ml/hr per doctor’s order.

7. Weigh child on same scale at same time each day and compare to previous weight.

8. Monitor lab tests.

1. Rigorous hand hygiene reduces bacterial counts on the hands and reduces the transmission of pathogens to clients and personnel.

2. Provides assurance of security and follows hospital protocol. Also prevents correct medication administration.

3. Vital signs: Severe dehydration resulting from extracellular fluid loss and reduced circulating blood volume cause hypovolemia. The body will try to compensate for the fluid loss by increasing the heart rate and increasing the respiratory rate and lowering the blood pressure and temperature.

4. Frequent assessment of hydration status facilitates rapid intervention and evaluation of the effectiveness of fluid replacement. Mucus membranes will be dry in moderate dehydration. Skin turgor will be poor because of decreased interstitial fluid and the capillary refill will be >2 seconds because of decreased intravascular volume. In gastroenteritis initial dehydration in the first 3 days reflects a high loss of extracellular fluid. The deficit occurs when there is not enough fluid in the extracellular compartment.

5. Recognition if I & O is important to identify a client that is at risk for fluid, electrolyte, and acid-base disturbances. The information helps maintain an ongoing evaluation of the client’s hydration status to prevent severe imbalances.

6. Hypertonic solution commonly used as a maintenance fluid. It can be used as an initial fluid for hydration because it provides more water than sodium.

7. Losing up to 5% of body weight indicated mild dehydration; 6-9% is moderated & 10% or more is indicative to severe dehydration. Weight loss occurs because of a decrease in fluid volume.

8. Monitor serum sodium daily because elevated serum sodium concentration causes brain cell shrinkage and decreased level of consciousness.