A 3-year-old with diarrhea, nausea, and vomiting for the past two days. After ondansetron is given, which is the most important aftercare instruction at discharge?

A 3-year-old with diarrhea, nausea, and vomiting for the past two days. After ondansetron is given, which is the most important aftercare instruction at discharge?

• A. Start intravenous fluids
• B. Stop fluids until vomiting subsides
• C. Begin oral rehydration with small volumes of electrolyte solution
• D. Return if vomiting recurs soon

Answer: (C)

The main idea is to restore fluids and electrolytes by mouth. After an antiemetic, starting oral rehydration with small sips of an electrolyte solution is the best discharge instruction because it directly treats dehydration in a safe, effective way for a child who can tolerate oral intake. Oral rehydration solutions use glucose and electrolytes to promote water absorption in the intestines, rebalancing losses from diarrhea and vomiting without the need for IV access. IV fluids are only needed if the child cannot keep fluids down or is severely dehydrated or in shock. Stopping fluids would worsen dehydration, and while telling caregivers to return if vomiting recurs is reasonable, the critical step is initiating oral rehydration now.

The main idea is to restore fluids and electrolytes by mouth. After an antiemetic, starting oral rehydration with small sips of an electrolyte solution is the best discharge instruction because it directly treats dehydration in a safe, effective way for a child who can tolerate oral intake. Oral rehydration solutions use glucose and electrolytes to promote water absorption in the intestines, rebalancing losses from diarrhea and vomiting without the need for IV access. IV fluids are only needed if the child cannot keep fluids down or is severely dehydrated or in shock. Stopping fluids would worsen dehydration, and while telling caregivers to return if vomiting recurs is reasonable, the critical step is initiating oral rehydration now.