Questions for mother of sick child...

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A 12 month old's mother reports that the child loves her milk and usually drinks about 40 ounces per day. However, for the past day she has not wanted anything to eat or drink. Her mother wants to know if there is anything that the nurse can give the child to help stop the vomiting.

What questions does the nurse need to ask mother at this point?

Thanks for the help, guys. I'm stumped on this one.

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I would want to know the following:

When did the vomiting begin?

How many times has she vomited?

Is this the same milk she's always been drinking?

Have any new foods been introduced to her diet?

Is she acting differently than usual (not playng, wanting to be held more, etc)?

Has the mother given her any medications for the vomiting?

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Great answer... thanks so much!

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Specializes in Pediatric/Adolescent, Med-Surg.

All good questions posted in previous post. I would also discourage the mom from trying to feed the child milk until vomiting has resolved as it may further upset the child's stomach. I would encourage the mother to try to give the child some Pedialyte so the child can stay hydrated.

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Specializes in Trauma, Teaching.

Is the child lethargic? not responding well?

Is she making tears when she cries, or making fewer than the usualy number of wet diapers?

Any diarrhea? How watery is it?

Running a fever? How high?

Any rash? any allergies?

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A 12 month old's mother reports that the child loves her milk and usually drinks about 40 ounces per day. However, for the past day she has not wanted anything to eat or drink. Her mother wants to know if there is anything that the nurse can give the child to help stop the vomiting.

What questions does the nurse need to ask mother at this point?

Thanks for the help, guys. I'm stumped on this one.

When I first read this, I took it as the baby usually loves the mom's (her) milk, i.e. she is breastfeeding. However unless the mom is pumping it'd be difficult to gauge how many ounces she was drinking per day. If the child is drinking cow's milk or formula, 40 oz/day is way too much. By that age they usually want them on 12 to 22 oz per day with the rest of their calories coming from solids. And they usually don't start on regular cow's milk until 1 year. In any case, I'd ask the following questions:

if mom is breastfeeding:

changes to mom's diet

any illness or new medications/supplements for mom

if it's formula:

is it the same brand

is the water used to prepare it the same

how much is usually given at each feeding

what solids are normally eaten and is there anything new

in general:

other symptoms in the baby

when did it start, how soon after feeding does it occur

any diarrhea

any constipation

anything new introduced to baby recently - food, toys, animals, etc

temperature

how irritable is the baby

lethargy

if it's looking like it's just gastro...

the suggestion would be to stop formula or milk. wait 1 hour after the last vomit and then give small amounts of pedialyte every 15 minutes. if vomiting occurs then wait another hour before trying again. education about signs of dehydration like tenting of skin and sunken fontanel. if no improvement by tomorrow, take child in. don't give any medications except tylenol. even if there is no fever the child might benefit from tylenol because of painful stomach cramping - they might get some relief and be able to sleep.

if the woman is breastfeeding, i believe it's recommended to continue to do so. i'm not entirely sure about this but i think it'd be best to express the milk and give small amounts frequently.

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