A 2-year-old child has acute watery diarrhea for 1 day, normal skin turgor, and no signs of dehydration. What is the appropriate initial management?

Appeared in: PGIMER Nursing Officer - 2025

Explanation

Children with acute watery diarrhea and no dehydration should be managed at home with ORS, adequate fluids, and continued feeding.
Early feeding supports gut healing and prevents malnutrition.
IV fluids and antibiotics are not needed unless dehydration or systemic infection develops.
Nil by mouth is contraindicated as it worsens nutritional status.
Key differentiator: Absence of dehydration signs means home management is safest.

Option B: ICU admission and IV fluids are reserved for children with severe dehydration or shock, not for those with no dehydration.
Option C: IV antibiotics are not indicated for acute watery diarrhea without signs of systemic infection or dysentery.
Option D: Nil by mouth (NPO) is harmful in diarrhea management and increases risk of malnutrition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Initial management of acute watery diarrhea in children without dehydration as background academic context rather than a clinical decision trigger.
Nurses play a key role in educating caregivers about signs of dehydration and correct ORS preparation.
Early home management prevents unnecessary hospital admissions and complications.
What if? If the child develops signs of dehydration (sunken eyes, poor skin turgor, lethargy), escalate to Plan B or C with possible hospital referral.

How to Approach the Question

Identify the clinical scenario: acute watery diarrhea, no dehydration.
Recall the WHO/Indian guidelines for diarrhea management (Plan A, B, C).
Eliminate options that involve unnecessary escalation (IV fluids, antibiotics, NPO).
Choose the option that matches home-based, supportive care with ORS and continued feeding.

Concept Tested & Keywords

Concept Tested: Initial management of acute watery diarrhea in children without dehydration
Stem keywords: 2-year-old child, acute watery diarrhea, normal skin turgor, no signs of dehydration, initial management
Lead-in keywords: appropriate, initial management
Clinical cues: No dehydration: normal skin turgor, alert, moist mucosa

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 311-313, 313-315

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 153-155

Practise the full PGIMER Nursing Officer - 2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.