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P104

Can you-

Assess the hydration status of paediatric patients using a systematic approach?

Take a hydration history from care givers (intake/output)?

Initiate hydration interventions?

Describe the different products used in the ED to re- hydrate children?

Recognise when a child may require more aggressive hydration therapy ie: NGT / PIVC?

Setup for and assist with PIVC insertion and securing?

Explain the rationale for anti-emetics in children and instances they should be given.

Know & Show Assessment Tool: 

   
Explain
Signs and symptoms of a dehydrated paediatric patient 
  • Lethargy, absent tears, decreased LOC, skin turgor, fontanel changes (if applicable), dry mucous membranes, tachycardia, sunken eyes 

 

Identify 3 relevant questions to ask caregivers in relation to paediatric hydration history (intake vs output) 
  • - Eating/drinking normally? 
  • - Same wet nappies? 
  • - Diarrhoea/vomiting? Amount? 
List age appropriate hydration interventions for paediatric patients in your ED
 
What are commonly used anti emetics in your ED for paediatric patients? And at what stage should they be administered? 
 
Discuss the possible hydration interventions/medications appropriate for the paediatric patients with the following triage notes:  
• 12 MONTH OLD FEMALE BIB PARENTS, C/O 3/7 HX OF DIARRHOEA AND VOMITING. DEC INTAKE/WET NAPPIES. O/E:LETHARGIC, SUNKEN ANTERIOR FONTANELLE, CR >3SEC, RR-40, HOT TO TOUCH 5 YEAR OLD MALE 
• 12 MONTH OLD FEMALE BIB PARENTS, C/O 5/7 OF INTERMITANT FEVER AND VOMITING NORMAL 
INTAKE/OUTPUT, X2 VOMITS TODAY. NAUSEOUS .O/E: ALERT, INTERACTIVE, SLIGHTLY 
DRY MUCOUS MEMBRANES, NON DISTRESSED,PR- 92 
9 MONTH OLD MALE 
• 12 MONTH OLD FEMALE AEROMEDICAL RETRIEVAL FROM REMOTE COMMUNITY, ONGOING DIARRHOEA FOR 3/7, NO VOMITING, 
CONTINUES BREAST FEEDING, NIL PMH, O/E: ALERT, SLIGHTLY SUNKEN EYES, MOD SUNKEN ANTERIOR FONTANELLE, HR-145, RR-32,T-37.7 

 

A severely dehydrated child requires IVT. A bolus dose of N/saline is calculated at? 
a) 5mls/kg b)25mls/kg c)50mls/kg d)20mls/kg 
 
A child weighing 11.2kg is ordered an initial bolus dose of N/saline for fluid resuscitation. How many mL should the child receive? 
 
What is an appropriate strategy for assisting with PIVC insertion?

 

Demonstrate

Setup of NG feeding pump.

Use of burette for IV fluids.

 

Outcomes
Knowledge

Not yet able to correctly answer; or requires frequent prompting.

Able to correctly answer almost all questions with minimal prompting.

Answers correctly without prompting.

Skills Performance

Not yet correctly performing skill; or requires frequent prompting.

Performs correctly with some prompts and no critical errors.

Performs correctly without prompting.

Overall

Not yet completed.

Completed.

Assessor Feedback:

 

 

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Version: 
0.80