The following day the family returned due to a dramatic worsening of symptoms and Eddie’s refusal of oral fluids. His temperature was 100.5oF and his oxygen saturation via pulse oximetry was 94%. The lungs were clear to auscultation with decreased breath sounds on the left side. Eddie’s lips and mucous membranes were dry and he was not producing tears. He was diagnosed with dehydration and pneumonia. Eddie was referred to the emergency department with orders for a PA/lateral chest x-ray, complete blood count (CBC) with differential, complete metabolic panel (CMP) and intravenous (IV) fluids.