Dehydration Pediatric Care Plan

By David Shafran, MD
January 12, 2021

What is Dehydration?

The body needs water since water is a main component of blood. When your body loses too much water or doesn’t get enough water, it becomes more difficult for blood to reach the body’s organs. This problem is called dehydration. Younger children at higher risk for dehydration for a number of reasons. 

Causes of dehydration include:

  • Vomiting and diarrhea (most common)
  • Fever
  • Burns
  • Diabetes

Dehydration is classified as mild, moderate, or severe and symptoms include:

  • urinating less
  • dry mouth
  • very fussy or sleepy
  • marked decrease in activity
  • few or no tears when crying
  • wrinkled skin
  • sunken eyes

Dehydration Diagnosis & Treatment

Dehydration is diagnosed based on a history and physical exam. Based on this evaluation, the degree of your child’s dehydration can be assessed and the proper recommendations for management offered. See chart below for guidance.

Mild Dehydration

Symptoms of mild dehydration may include:

  • looks well
  • Isn’t thirsty
  • making tears
  • mouth isn’t dry
  • lips aren’t chapped

Management

  • Oral rehydration with pedialyte or water
  • If vomiting give small amounts every 5 minutes
  • If unable to keep fluids down, check in with K or call doctor

24 hour goal: at least 1 to 1-and-a-half ounces of fluid for every pound of body weight Example: 40 pound child needs at least 40-60oz of fluid in a 24 hour period

Moderate Dehydration

Symptoms:

  • fussy and irritable
  • thirsty
  • eyes look sunken
  • dry mouth
  • no tears

Management

  • Proceed to emergency room for rehydration through the the vein (IV)

24 hour goal: at least 2 to 2-and-a-half ounces of fluid for every pound of body weightExample: 40 pound child needs at least 80-100 ounces

Severe Dehydration

Symptoms:

  • lethargic
  • too sick to drink
  • sunken eyes
  • dry mouth
  • chapped lips

Management:

Go to the ER for IV rehydration as soon as possible.

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person…

  • Your child is unable to keep fluids down
  • Your child has vomiting for more than 3 days
  • Your child has diarrhea for more than 5 days
  • Go go the emergency room if your child becomes sleepy or lethargic
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.