Lab Case 172

6 month old female presents with 2 day history of watery diarrhoea and severe nappy rash.

. She has had poor oral intake, but mother is unsure of urine output due to the frequent stools. Baby was born at term BW 3KG. Recent weight at GP of 6KG. IUTD.

O/E Child unwell looking, irritable but consolable.  Weight 5.3KG

CPR >3 sec. HR 175 Temp 38.4 Sats 97% RA RR35

Sunken eyes with dry mucous membranes

Marked excoriation to perineum and buttocks, with markings that appear to be cigarette burns in different stages of healing

Abd-  generalised tenderness, no rebound or guarding and no organomegaly

VBG:

pH 7.2                                                                Sodium 132mmol/L

pCO2 34mmHg                                                  K 3.3mmol/l

pO2 37mmHg                                                     Chloride 109mmol/l

HCO3 13mmol/l                                                  Creatinine 17umol/L

BE -14                                                                 Glucose 5.1mmol/L

Saturation 62     %                                                Lactate 1.3mmol/L

 

  1. Describe and Interpret the above VBG
  2. What would be the management for this child