A nurse is caring for an 8-month-old child admitted with dehydration. Which of the following client findings indicates that oral rehydration therapy has been effective? (Select all that apply)

Choice A reason:

A specific gravity of 1.010 indicates that the child’s urine is adequately diluted, suggesting proper hydration. Normal urine specific gravity ranges from 1.005 to 1.030. A value of 1.010 falls within this range and indicates that the kidneys are functioning well and the child is not dehydrated.

Choice B reason:

Moist mucous membranes are a sign of adequate hydration. When a child is well-hydrated, the mucous membranes in the mouth and other areas remain moist. This is a positive indicator that oral rehydration therapy has been effective in restoring the child’s fluid balance.

Choice C reason:

Capillary refill time of less than 3 seconds is another indicator of proper hydration and good peripheral perfusion. This means that the blood is circulating well throughout the body, and the tissues are receiving adequate oxygen and nutrients. A capillary refill time of less than 3 seconds is considered normal and suggests effective rehydration.

Choice D reason:

A sunken anterior fontanelle is a sign of dehydration in infants. When the fontanelle is sunken, it indicates that the child has lost a significant amount of fluid. Therefore, this finding does not indicate that oral rehydration therapy has been effective. Instead, it suggests that the child may still be dehydrated.

Choice E reason:

A heart rate of 146/min is elevated for an 8-month-old child1. Normal heart rates for infants range from 80 to 160 beats per minute. While this heart rate is within the upper limit of normal, it can also be a sign of dehydration or other stressors. Therefore, it is not a definitive indicator of effective rehydration therapy.

Choice A reason:

Oral rehydration solution (ORS) is the first-line treatment for children with acute diarrhea and moderate dehydration. ORS contains a precise balance of electrolytes and glucose, which helps to rehydrate the child effectively by promoting the absorption of water and electrolytes in the intestines. The World Health Organization (WHO) and the American Academy of Pediatrics recommend ORS as the preferred treatment for dehydration caused by diarrhea. It is effective, easy to administer, and can be given at home or in a healthcare setting.

Choice B reason:

Antidiarrheal medications such as paregoric are not recommended for children with acute diarrhea. These medications can slow down the movement of the intestines, which may prolong the infection and increase the risk of complications. Additionally, they do not address the underlying cause of dehydration. The primary goal in managing acute diarrhea is to rehydrate the child, which is best achieved with ORS.

Choice C reason:

Clear liquids, such as water, broth, or diluted fruit juices, can be used to provide some hydration, but they do not contain the necessary electrolytes to effectively treat moderate dehydration. Clear liquids alone are not sufficient to replace the lost electrolytes and fluids caused by diarrhea. ORS is specifically formulated to address these needs and is more effective in rehydrating the child.

Choice D reason:

Adsorbents, such as kaolin and pectin, are not recommended for the treatment of acute diarrhea in children. These substances can bind to the contents of the intestines and may reduce the frequency of stools, but they do not address the underlying dehydration. The primary focus should be on rehydration with ORS, which provides the necessary electrolytes and fluids to restore the child’s hydration status.