A 2-year-old child presents with acute diarrhea but shows no signs of dehydration. Oral Rehydration Solution (ORS) is prescribed. How much ORS should be given after each loose stool?

1. A

   50–100 mL

2. B

   30–50 mL

3. C

   100–200 mL

4. D

   200–300 mL

Appeared in: NORCET 10 Prelims-2026

Explanation

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• According to WHO guidelines for Treatment Plan A (no dehydration), the recommended amount of ORS for a child up to 24 months of age is 50–100 mL after each loose stool.
• A 2-year-old child is 24 months old, placing them in this dosage category.
• This amount is sufficient to replace fluid losses from diarrhea and prevent the development of dehydration.
• The goal of Treatment Plan A is to manage diarrhea at home by giving extra fluids and continuing to feed the child.

Why Other Options Were Wrong

• Option B: This volume is too low and clinically insufficient to replace fluid losses from diarrhea for a child of any age, increasing the risk of developing dehydration.
• Option C: This dosage is recommended for children aged 2 to 10 years. While the child is 2, the lower range is preferred for a child at the beginning of this age bracket, making 50-100mL the safer and more common recommendation.
• Option D: This amount is excessive for a 2-year-old after a single loose stool and could lead to vomiting.

Related Visual

• Visual 1: Chart: WHO Treatment Plan A guidelines showing ORS dosage by age.
• Visual 2: Image: A packet of low-osmolarity ORS with its composition listed.
• Visual 3: Infographic: Signs of no dehydration vs. some dehydration in a child (e.g., skin turgor, sunken eyes, thirst).

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Oral Rehydration Therapy (ORT) dosage for pediatric diarrhea as background academic context rather than a clinical decision trigger.
• Nurses are central to educating caregivers on the '4 Rules of Home Treatment': give extra fluid (ORS), continue feeding, know when to return to the clinic, and give zinc supplements for 14 days.
• Accurate dosing is critical. Underdosing can fail to prevent dehydration, while overdosing is less risky but can cause vomiting or be wasteful.
• What if? If the child showed signs of 'some dehydration' (e.g., restless, thirsty, sunken eyes), they would need WHO Treatment Plan B. This involves supervised administration of 75 mL/kg of ORS over 4 hours in a health facility.

How to Approach the Question

• First, identify the key clinical details from the question: the patient's age (2 years), their condition (acute diarrhea), and their hydration status (no signs of dehydration).
• Recognize that 'no dehydration' points directly to using WHO Treatment Plan A for home management.
• The question asks for the specific amount of ORS to give after each loose stool. This requires recalling the standard age-based dosages.
• Recall the WHO age categories for Plan A: up to 24 months and 2 to 10 years.
• Place the 2-year-old (24 months) child in the correct category. The 'up to 24 months' category is the most appropriate for a child of this exact age.
• Select the option that matches the recommended dosage range for the 'up to 24 months' age group, which is 50-100 mL.

Concept Tested & Keywords

• Concept Tested: Oral Rehydration Therapy (ORT) dosage for pediatric diarrhea.
• Stem keywords: 2-year-old child, acute diarrhea, no signs of dehydration, Oral Rehydration Solution (ORS), after each loose stool
• Lead-in keywords: How much
• Clinical cues: Patient age is 2 years (24 months), which is a key factor for dosage.
• Clinical cues: Hydration status is 'no dehydration', indicating WHO Treatment Plan A is appropriate.

Question ID

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