A 7 year old girl is brought to the emergency room by EMS after having a history of fever and having emesis and diarrhea for the past 3 days. She has a history of wheezing with viral illnessess. Immunizations are up to date for age.  Family history reveals that family members are well other than 2 siblings who have had diarrhea. Social history is unremarkable. Upon examination, the patient appears unwell. The patient is responsive but lethargic. The neurological,respiratory, and skin exams appears normal. The cardiovascular examination shows normal heart sounds. Mucous membranes are dry, pulses are palpable but weak, capillary refill is 5 seconds centrally and peripherally. The abdominal examination reveals vague and diffuse pain.