K10 · Infant dehydration risk
Risk Child and teen
Definition
Infants can lose body water quickly through vomiting, diarrhea, or poor feeding.- Vomiting
- diarrhea
- fever
- poor feeding
- heat
- Sunken soft spot
- dry mouth
- fewer wet diapers
- lethargy
📋 Scenario
A 10-month-old with one day of vomiting is feeding poorly.
Subjective (S): Parent: "She vomits after every feed."
Objective (O): Vomiting 5 times today; breastfeeds poorly; 4 wet diapers in 24 hours; soft spot flat; mouth moist; temperature 37.9 C.
Assessment tools for this scenario: CP-CHILD Child & Teen Check CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: PEWS, FLACC, MUST, fluid chart, glucose
**CarePath diagnosis:** Infant dehydration risk related to vomiting, poor feeding and fever (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Give oral rehydration. | Small, frequent sips of oral rehydration solution replace water and salts lost in vomiting without overloading the stomach, so fluid is more likely to stay down. |
| Breastfeed. | Breast milk is easily digested and gives fluid and nutrition, and continued feeding keeps intake up and comforts the baby while she is unwell. |
| Monitor diapers. | Counting wet diapers is a simple, reliable way to see whether enough fluid is going in, so falling urine output is caught early. |
| Seek urgent care for lethargy. | Lethargy means dehydration may be becoming serious, and infants worsen quickly, so prompt medical assessment and possible intravenous fluids are needed. |
**Expected outcomes**
- Wet diapers return to at least 6 per day.
- Takes fluids.
- Alert and active.
- No dehydration.
**Linking the data to the diagnosis**
The parent says the 10-month-old vomits after every feed. She has vomited 5 times today, breastfeeds poorly and has a temperature of 37.9 C. However, she has 4 wet diapers in 24 hours, a flat soft spot and a moist mouth, so dehydration has not occurred. This is why a risk statement fits, not an actual dehydration diagnosis, and it rests on vomiting, poor feeding and fever. The plan aims to replace fluid before loss builds up, bringing wet diapers back to at least 6 per day, keeping her taking fluids and alert, and preventing dehydration.
CarePath diagnosis
Infant dehydration risk related to vomiting, poor feeding and fever (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Give oral rehydration. | Small, frequent sips of oral rehydration solution replace water and salts lost in vomiting without overloading the stomach, so fluid is more likely to stay down. |
| 2. Breastfeed. | Breast milk is easily digested and gives fluid and nutrition, and continued feeding keeps intake up and comforts the baby while she is unwell. |
| 3. Monitor diapers. | Counting wet diapers is a simple, reliable way to see whether enough fluid is going in, so falling urine output is caught early. |
| 4. Seek urgent care for lethargy. | Lethargy means dehydration may be becoming serious, and infants worsen quickly, so prompt medical assessment and possible intravenous fluids are needed. |
Expected outcomes
- Wet diapers return to at least 6 per day.
- Takes fluids.
- Alert and active.
- No dehydration.
Linking the data to the diagnosis
The parent says the 10-month-old vomits after every feed. She has vomited 5 times today, breastfeeds poorly and has a temperature of 37.9 C. However, she has 4 wet diapers in 24 hours, a flat soft spot and a moist mouth, so dehydration has not occurred. This is why a risk statement fits, not an actual dehydration diagnosis, and it rests on vomiting, poor feeding and fever. The plan aims to replace fluid before loss builds up, bringing wet diapers back to at least 6 per day, keeping her taking fluids and alert, and preventing dehydration.