A 1-month old infant is admitted to the emergency room with severe diarrhea. Which of the following assessments suggests the infant is severely dehydrated?

A. A high specific gravity of urine typically indicates concentrated urine, which can occur in dehydration; however, moist mucous membranes suggest adequate hydration. This combination does not indicate severe dehydration.
B. A low specific gravity of urine usually indicates dilute urine, which is not typical in dehydration; it suggests the kidneys are not concentrating urine due to good fluid intake or other factors. While pale skin can indicate poor perfusion, this option does not specifically indicate severe dehydration.
C. A depressed fontanelle (soft spot on the head) and a capillary refill time greater than 4 seconds are significant indicators of severe dehydration in infants. Depressed fontanelles suggest that the infant is not receiving enough fluids, and prolonged capillary refill time indicates poor perfusion and dehydration.
D. Moist skin and mucous membranes indicate adequate hydration. Flushed skin may occur with certain conditions but does not suggest severe dehydration. This option reflects a well-hydrated status rather than dehydration.

A. Antacids are typically used to neutralize stomach acid, which can provide relief for ulcer-related pain. If the pain worsens with antacids, it may suggest another underlying issue, such as a gastric ulcer or a different gastrointestinal condition.
B. This statement is more typical of gastric ulcers, where pain may occur shortly after eating due to increased gastric acid secretion. In duodenal ulcers, pain typically occurs a few hours after meals.
C. Duodenal ulcer pain often improves with eating because food temporarily buffers stomach acid, which can provide relief. Patients may find that their pain is relieved for a time after eating, as the food helps protect the ulcer.
D. This statement is not typically associated with duodenal ulcers. While some patients may experience variations in pain during the night, the relief during sleep is not a characteristic feature. The pain is usually more related to the timing of meals rather than sleep.