Question
A 5-year-old child is brought to the emergency department with complaints of frequent loose stools. The mother notes that the child is irritable and eagerly consumes water. On physical examination, the child displays sunken eyes and a positive skin pinch test with delayed retraction, indicative of dehydration. What is the most suitable management for this patient?
| A. |
Administer the first dose of IV antibiotic and immediately refer to a higher center
|
| B. |
Give oral fluids and ask the mother to continue the same and visit again the next day
|
| C. |
Give zinc supplementation and oral rehydration solution only and ask mother to come back if some danger signs develop
|
| D. |
Consider severe dehydration, start intravenous (IV) fluids, IV antibiotics, and refer to a higher center
|
Show Answer
|
Correct Answer » C
Explanation
|
|
Management uses WHO/IMNCI dehydration criteria. This child’s findings—irritable, eagerly drinks, sunken eyes, slow skin pinch—match *some dehydration*.
Classification summary:
– *Some dehydration*: restless/irritable, sunken eyes, drinks eagerly, skin pinch slow to return
– *Severe dehydration*: lethargic/unconscious, unable to drink, very sunken eyes, skin pinch very slow
This child needs Plan B management:
– Oral rehydration solution (ORS)
– Zinc supplementation (20 mg daily × 14 days if >6 months old)
– Continue feeding
– Educate mother on danger signs
No IV fluids or antibiotics needed, as antibiotics aren’t routine for acute diarrhea.
IMNCI:
– Plan A: No dehydration—home fluids & feeding
– Plan B: Some dehydration—ORS + zinc
– Plan C: Severe dehydration—urgent IV fluids
