Advanced iHuman Clinical Simulation: Layla Stevens – An A+ Evidence-Based
Guide to Acute Viral Gastroenteritis, Dehydration Management, and Pediatric
Rehydration Protocols (2026 Edition)
,
,Section 1: Case Overview ...... 1
1.1 Patient Demographics ...... 1
1.2 Reason for Encounter ...... 1
1.3 Case Setting ...... 1
1.4 Clinical Significance ...... 2
Section 2: Chief Complaint & History of Presenting Illness (HPI) ...... 3
2.1 Chief Complaint ...... 3
2.2 History of Presenting Illness (OLDCARTS Framework) ...... 3
2.3 Key Historical Details ...... 4
Section 3: Past Medical History (PMH) ...... 6
3.1 Birth History ...... 6
3.2 Immunization Status ...... 6
3.3 Past Illnesses & Hospitalizations ...... 6
3.4 Allergies ...... 6
3.5 Medications ...... 7
3.6 Growth & Developmental Milestones ...... 7
Section 4: Family History & Social History ...... 8
4.1 Family History ...... 8
4.2 Social History ...... 8
Section 5: Review of Systems (ROS) ...... 9
5.1 Constitutional ...... 9
5.2 HEENT ...... 9
5.3 Cardiovascular ...... 10
5.4 Respiratory ...... 10
5.5 Gastrointestinal ...... 10
5.6 Genitourinary ...... 10
5.7 Integumentary ...... 10
5.8 Neurological ...... 11
Section 6: Physical Examination ...... 12
, 6.1 General Appearance ...... 12
6.2 Vital Signs ...... 12
6.3 Growth Parameters ...... 13
6.4 HEENT Examination ...... 13
6.5 Cardiovascular Examination ...... 14
6.6 Respiratory Examination ...... 14
6.7 Abdominal Examination ...... 14
6.8 Genitourinary Examination ...... 15
6.9 Neurological Examination ...... 15
6.10 Skin Examination ...... 15
Section 7: Dehydration Assessment ...... 16
7.1 Clinical Dehydration Scale (CDS) ...... 16
7.2 WHO Dehydration Classification ...... 17
7.3 Weight Loss as Dehydration Indicator ...... 17
7.4 Signs & Symptoms of Dehydration by Severity ...... 18
Section 8: Diagnostic Workup ...... 19
8.1 Laboratory Studies ...... 19
8.2 Basic Metabolic Panel (BMP) ...... 19
8.3 Complete Blood Count (CBC) ...... 20
8.4 Additional Labs ...... 20
8.5 Stool Studies ...... 20
8.6 Imaging ...... 21
Section 9: Differential Diagnosis ...... 22
9.1 Differential Diagnosis Table ...... 22
9.2 Must-Not-Miss Diagnoses ...... 23
9.3 Clinical Reasoning & Prioritization ...... 24
Section 10: Pathophysiology ...... 25
10.1 Rotavirus Gastroenteritis ...... 25
10.2 Mechanism of Dehydration ...... 26
10.3 Metabolic Consequences ...... 26
Section 11: Management Plan ...... 27
11.1 Rehydration Therapy Overview ...... 27
11.2 Oral Rehydration Therapy (ORT) ...... 27
11.3 Intravenous (IV) Fluid Therapy ...... 28
11.4 Nutritional Management ...... 29
Guide to Acute Viral Gastroenteritis, Dehydration Management, and Pediatric
Rehydration Protocols (2026 Edition)
,
,Section 1: Case Overview ...... 1
1.1 Patient Demographics ...... 1
1.2 Reason for Encounter ...... 1
1.3 Case Setting ...... 1
1.4 Clinical Significance ...... 2
Section 2: Chief Complaint & History of Presenting Illness (HPI) ...... 3
2.1 Chief Complaint ...... 3
2.2 History of Presenting Illness (OLDCARTS Framework) ...... 3
2.3 Key Historical Details ...... 4
Section 3: Past Medical History (PMH) ...... 6
3.1 Birth History ...... 6
3.2 Immunization Status ...... 6
3.3 Past Illnesses & Hospitalizations ...... 6
3.4 Allergies ...... 6
3.5 Medications ...... 7
3.6 Growth & Developmental Milestones ...... 7
Section 4: Family History & Social History ...... 8
4.1 Family History ...... 8
4.2 Social History ...... 8
Section 5: Review of Systems (ROS) ...... 9
5.1 Constitutional ...... 9
5.2 HEENT ...... 9
5.3 Cardiovascular ...... 10
5.4 Respiratory ...... 10
5.5 Gastrointestinal ...... 10
5.6 Genitourinary ...... 10
5.7 Integumentary ...... 10
5.8 Neurological ...... 11
Section 6: Physical Examination ...... 12
, 6.1 General Appearance ...... 12
6.2 Vital Signs ...... 12
6.3 Growth Parameters ...... 13
6.4 HEENT Examination ...... 13
6.5 Cardiovascular Examination ...... 14
6.6 Respiratory Examination ...... 14
6.7 Abdominal Examination ...... 14
6.8 Genitourinary Examination ...... 15
6.9 Neurological Examination ...... 15
6.10 Skin Examination ...... 15
Section 7: Dehydration Assessment ...... 16
7.1 Clinical Dehydration Scale (CDS) ...... 16
7.2 WHO Dehydration Classification ...... 17
7.3 Weight Loss as Dehydration Indicator ...... 17
7.4 Signs & Symptoms of Dehydration by Severity ...... 18
Section 8: Diagnostic Workup ...... 19
8.1 Laboratory Studies ...... 19
8.2 Basic Metabolic Panel (BMP) ...... 19
8.3 Complete Blood Count (CBC) ...... 20
8.4 Additional Labs ...... 20
8.5 Stool Studies ...... 20
8.6 Imaging ...... 21
Section 9: Differential Diagnosis ...... 22
9.1 Differential Diagnosis Table ...... 22
9.2 Must-Not-Miss Diagnoses ...... 23
9.3 Clinical Reasoning & Prioritization ...... 24
Section 10: Pathophysiology ...... 25
10.1 Rotavirus Gastroenteritis ...... 25
10.2 Mechanism of Dehydration ...... 26
10.3 Metabolic Consequences ...... 26
Section 11: Management Plan ...... 27
11.1 Rehydration Therapy Overview ...... 27
11.2 Oral Rehydration Therapy (ORT) ...... 27
11.3 Intravenous (IV) Fluid Therapy ...... 28
11.4 Nutritional Management ...... 29
