After my evaluation, the child did not appear significantly dehydrated. Was awake, and alert, and was febrile. We attempted oral feeding and observed the child for the next several hours. During this time, I witness the child taking small amounts of milk from the bottle but no large quantities are taken and over 2 1/2 to 3 hours time. The diaper remained dry.
At that point, with no further appealed intake and concerns about dehydration, we decide to place an IV and that time also added some blood work that include a blood culture, CB, and comprehensive panel and I did a chest x- ray. Chest x-ray did not show any focal infiltrate or other abnormalities. Glucose 78,Ball 8,creating 0. 4. Normal electrolytes. Normal liver function. Whites counts of 0. 9, homoerotic 34, platelets 398 with an unremarkable differential. Two 20 c/keg normal saline boluses were given for a total of 250 c.
The child tolerated this very well. She remains awake, and alert, and did wet the diaper. And this time, I think she can be safely discharged. I did speak with the primary care pediatrician about this patient and to secure follow up on Monday.