Nursing History
Patient: Eva Madison; Informant: Her mother and self; Age: 5 years; Gender: Female
Admitting diagnosis: dehydration
Children belong to a group of people who are vulnerable to dehydration due to their age and the lack of knowledge about major sanitation rules. Children are not able to identify and explain their concerns or meet their basic needs properly. Pediatric dehydration is a result of gastroenteritis that is usually characterized by vomiting and diarrhea (Anigilaje, 2018). The negative fluid balance causes dehydration and provokes fluid shifts that have to be monitored and controlled (Anigilaje, 2018). Dry mouth, sunken eyes, and listlessness are the main signs.
Chief complaint: vomiting and nausea
History of present illness: inability to keep fluids down during the last three days
Allergies: no known
Medications: none
Past medical history: no information
Immunization: no information
Psychosocial history: no information
Family history: no information
Reference
Anigilaje, E. A. (2018). Management of diarrhoeal dehydration in childhood: A review for clinicians in developing countries. Frontiers in Pediatrics, 6.