A 4-year-old with gastroenteritis has clinical dehydration but no shock. Frequent small oral rehydration solution volumes repeatedly provoke vomiting

Question

A 4-year-old with gastroenteritis has clinical dehydration but no shock. Frequent small oral rehydration solution volumes repeatedly provoke vomiting and the child cannot drink enough, although observations remain stable. What is the next appropriate rehydration step?

Accepted Answer

Consider ORS through a nasogastric tube with close reassessment

Answer

Continue unrestricted oral boluses of ORS despite recurrent vomiting

Answer

Start maintenance intravenous fluid without attempting enteral rehydration

Answer

Start rapid intravenous 0.45% sodium chloride because oral treatment has failed

Answer

Change to diluted fruit juice by mouth and reassess after four hours

Oral rehydration — GPhC CRA MCQ

A 4-year-old with gastroenteritis has clinical dehydration but no shock. Frequent small oral rehydration solution volumes repeatedly provoke vomiting and the child cannot drink enough, although observations remain stable. What is the next appropriate rehydration step?