Pediatric Fever and Dehydration

A fever is a temperature finding; dehydration is a loss of body fluid that can progress to impaired tissue and kidney perfusion. The combination becomes dangerous when fever reduces a child’s intake while vomiting, diarrhoea, or rapid breathing increases fluid loss. The temperature itself does not tell you how dehydrated the child is. The experienced nurse looks first at appearance, interaction, circulation, urine output, and the ability to drink. A quiet, difficult-to-arouse child with delayed capillary refill is more urgent than an alert child with a higher temperature but normal perfusion. In a child 90 days or younger, however, any temperature of 38.0 °C or higher requires urgent assessment even when the infant initially appears well.