Key Questions for Pediatric Gastroenteritis Follow-up
During a pediatric gastroenteritis follow-up visit, you should systematically assess hydration status, symptom resolution, and complications through specific targeted questions about fluid intake/output, symptom progression, and warning signs.
Hydration Assessment Questions
- Has the child's fluid intake improved since the last visit?
- How many wet diapers or urinations has the child had in the past 24 hours?
- Is the child still experiencing vomiting? If so, how frequently?
- Has the diarrhea improved, worsened, or stayed the same? How many loose stools in the past 24 hours?
- Are you noticing any signs of dehydration such as:
- Decreased tears when crying
- Dry mouth or tongue
- Sunken eyes or fontanelle (in infants)
- Decreased activity or lethargy
- Decreased skin turgor (skin pinch test)
Symptom Resolution Questions
- Has the fever resolved? When was the last time you recorded a fever?
- Has the child's appetite returned to normal?
- Is the child able to tolerate their regular diet?
- For infants: How is breastfeeding or formula feeding going? 1
- For older children: Is the child able to eat solid foods without discomfort?
Complications and Warning Signs
- Have you noticed any blood in the stool?
- Has the child complained of abdominal pain? If so, is it constant or intermittent?
- Has there been any unusual behavior or excessive sleepiness?
- Has the child had any rash or other new symptoms?
- For infants with formula: Have you made any changes to the formula? 1
- For breastfed infants: Have you made any changes to your diet? 1
Treatment Compliance Questions
- Were you able to provide oral rehydration as recommended?
- If oral rehydration solution was recommended, was the child able to tolerate it?
- Have you been able to follow the feeding recommendations we discussed?
- If medications were prescribed (such as ondansetron), did you use them and did they help? 2
Impact on Quality of Life
- How has the illness affected the child's daily activities and behavior?
- Has the child been able to return to normal activities/daycare/school?
- How has the illness affected the family's routine? 1
- What concerns or worries do you have about your child's condition? 1
Prevention Questions
- Has anyone else in the household developed similar symptoms?
- Have you been able to maintain handwashing and other hygiene measures?
- Is the child's rotavirus vaccination up to date? 1
Follow-up Plan
- Ask if the parents have any additional questions or concerns
- Determine if additional follow-up is needed based on symptom resolution
- Discuss when to seek immediate medical attention if symptoms worsen
Special Considerations
- For children with recurrent gastroenteritis episodes, consider asking about potential triggers or underlying conditions
- For infants, pay special attention to weight changes since the initial visit 1
- For children with severe initial presentation, assess for post-infectious complications
Remember that infants and young children are more vulnerable to dehydration due to their higher body surface-to-weight ratio, higher metabolic rate, and dependence on caregivers for fluid intake 1. The follow-up assessment should focus primarily on ensuring adequate hydration and nutritional intake have been restored.