NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesEasy
An EMT is assessing a 6-month-old infant who is lethargic, has a sunken fontanelle, dry mucous membranes, and decreased urine output. The infant's parents report a 2-day history of vomiting and diarrhea. Which of the following is the most likely underlying condition?
- AMeningitis
- BSepsis
- CDehydration
- DIntussusception
Show answer & explanationAnswer & explanation
Correct answer: C. Dehydration
The symptoms of lethargy, sunken fontanelle, dry mucous membranes, and decreased urine output in an infant with a history of vomiting and diarrhea are classic signs of dehydration. While sepsis and meningitis can cause lethargy, they don't typically present with all these specific signs of fluid loss. Intussusception causes intermittent abdominal pain and 'currant jelly' stools, which are not described here.
Why the other options are wrong
- A. Meningitis causes lethargy, fever, irritability, and sometimes a bulging fontanelle, not a sunken one or dry mucous membranes.
- B. Sepsis can cause lethargy and poor feeding but typically includes fever, poor perfusion, and less specific signs of fluid loss.
- D. Intussusception typically presents with sudden, severe, intermittent abdominal pain, drawing legs to chest, and 'currant jelly' stools, not the signs of dehydration described.
Pediatric Dehydration Signs
Clinical indicators in infants and children suggesting significant fluid loss, often due to vomiting, diarrhea, or reduced fluid intake.
- Sunken fontanelle (in infants), dry mucous membranes, decreased skin turgor.
- Reduced urine output, absence of tears when crying.
- Lethargy, irritability, increased heart rate, weak pulses.
- Capillary refill time >2 seconds.
Memory trick: FONTANELLE Sinks, MOUTH Dries, PEE Less, ENERGY Low = Dehydrated Flow!