An 11-month-old boy is brought to the emergency department for diarrhea and vomiting. The mother tells the nurse that her doctor said to "force fluids." She asks how much she should force the child to drink. How would you answer her?

"Forcing fluids is not forcing your child to drink fluids, but to offer fluids frequently."

Explanation

• Forcing fluids doesn’t literally involve forcing the child to drink fluids. Excessive fluid intake may also contribute to diarrhea.

• For a short time, infants are kept NPO to minimize the risk of vomiting. After that, infants may be allowed small sips of clear fluid, an oral rehydration solution, or breast milk. Gradually, the infant’s oral intake is increased, changing to soft then regular diet.

• With patients with diarrhea, it is very important to regulate electrolyte and fluid balance by oral or IV rehydration therapy.

• Diarrhea in infants is always serious because water accounts for 75% of infant body weight and infants have such a small extracellular fluid reserve. Sudden losses of water exhaust the supply quickly.

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