Question
In malnourished children, the following parameters are reliable indicators of dehydration except –
| A. |
Skin turgor |
| B. |
Dry buccal mucosa |
| C. |
Oliguria |
| D. |
Thirst |
|
Correct Answer » A Explanation |
 |
Assessment of dehydration in severely malnourished children (SAM) differs from normal kids, as many classic signs become unreliable.
Why usual signs fail:
– Malnutrition causes loss of subcutaneous fat
– Skin elasticity ↓
– Altered physiological responses
– These make some signs misleading
Reliable indicators per WHO:
– Thirst
– Dry buccal mucosa
– Sunken eyes (use cautiously)
– Level of consciousness (sensorium)
Why skin turgor is unreliable:
– Skin pinch remains slow even without dehydration
– Due to fat loss & poor skin elasticity
– Can overestimate dehydration
About oliguria:
– Not in standard WHO rapid dehydration charts
– Reflects renal perfusion & severity
– Clinically useful but not a primary bedside sign
– Not misleading like skin turgor, only less used in rapid checks
Reason to rule out other options:
– B. Dry buccal mucosa:_ Reliable indicator
– C. Oliguria:_ Reflects severity; reliable but not standard rapid sign
– D. Thirst:_ Reliable & important sign