In a pediatric patient with gastroenteritis presenting with vomiting and diarrhea, which finding supports proceeding with an oral rehydration challenge after antiemetic therapy?

• A. Abdominal tenderness
• B. Persistent vomiting
• C. Ability to tolerate oral fluids without vomiting
• D. Fever

Answer: (C)

The deciding factor for starting an oral rehydration challenge after antiemetic therapy is the patient’s ability to tolerate oral fluids without vomiting. When a child can hold down small sips of oral rehydration solution, it shows the gut can absorb fluids and electrolytes, allowing rehydration to proceed safely without immediately resorting to IV therapy. If vomiting persists, the risk of aspiration and poor absorption makes oral rehydration inappropriate at that moment, so IV fluids are warranted instead. Abdominal tenderness or fever on their own doesn’t indicate readiness for oral rehydration; they may reflect other issues, but they don’t confirm that oral intake can be maintained. The key signal is tolerating oral fluids without vomiting.