A client with a dehydrated child asks the nurse how to prevent dehydration.
What should the nurse educate the client about?

Sunken fontanelle (in infants).

C. Dry mucous membranes.

E. Lethargy.

Choice A rationale:

Sunken fontanelle (in infants) is a clinical sign of dehydration.

The fontanelle is the soft spot on an infant's head, and when it becomes sunken, it suggests that the child is dehydrated.

This occurs because a lack of adequate fluid causes the brain to temporarily shrink, leading to the sunken appearance.

Choice B rationale:

Increased urine output is not typically a sign of dehydration.

In fact, dehydration often leads to decreased urine output as the body attempts to conserve fluid.

Increased urine output can be a sign of other conditions, such as diabetes.

Choice C rationale:

Dry mucous membranes are a classic sign of dehydration.

When the body lacks sufficient fluids, the mucous membranes in the mouth and other areas can become dry and sticky.

This is an important clinical indicator of dehydration.

Choice D rationale:

Normal skin turgor is not a sign of dehydration.

Skin turgor refers to the skin's ability to bounce back when pinched and released.

In a hydrated individual, the skin should have good turgor.

Dehydration can lead to poor skin turgor, but normal skin turgor does not indicate dehydration.

Choice E rationale:

Lethargy is a potential sign of dehydration.

When a child is dehydrated, they may become lethargic or unusually tired because their body is not receiving the necessary fluids to function properly.

Lethargy can be an early sign of dehydration in children.

The correct answer is B. Shakiness.

Choice A: Increased capillary refill Capillary refill time (CRT) is a simple and quick test requiring minimal equipment or time to perform. Prolonged CRT is a ‘red flag’ feature, identifying children with increased risk of significant morbidity or mortality. A normal CRT should be between 2-3 seconds when applied centrally, such as to the sternum or the forehead. Therefore, increased capillary refill is not typically associated with hypoglycemia.

Choice B: Shakiness Shakiness, or tremors, are rhythmic shaking movements that most often happen in the hands, but can also occur in the arms, legs, head, vocal cords, and torso. Tremors can occur while a child is resting or active. Shakiness is a common symptom of hypoglycemia.

Choice C: Thirst While it’s true that excessive thirst can be a sign of diabetes, it’s a tricky one when the patient is a child. Young children often drink plenty of fluids when they are perfectly healthy. However, thirst is typically associated with hyperglycemia, not hypoglycemia.

Choice D: Decreased appetite Loss of appetite (anorexia) is a common symptom in children. Acute illness in childhood is often associated with transient loss of appetite. However, decreased appetite is not typically a direct symptom of hypoglycemia.