Dehydration in a child with diarrhoea, thirst present, tears absent is?

NHM UP Staff Nurse - 2016

Child Health Nursing (Pediatrics)

Easy

Appeared in: NHM UP Staff Nurse - 2016

Explanation

The combination of being thirsty (drinking eagerly) and having absent tears are two key clinical signs that define 'some dehydration' according to WHO/IMNCI guidelines.
'Some dehydration' is clinically categorized as moderate dehydration.
In this stage, the child is still responsive and able to drink, differentiating it from severe dehydration where lethargy and inability to drink are common.
The absence of tears signifies a more advanced state of dehydration than 'mild,' where tears would typically still be present.

Option A: Mild dehydration would not typically present with absent tears. While the child might be thirsty, other signs of significant fluid loss are usually not present.
Option C: Severe dehydration is characterized by more profound signs, such as lethargy, unconsciousness, very sunken eyes, and an inability to drink or drinking poorly. The child in the scenario is still thirsty and eager to drink.
Option D: The child is exhibiting clear signs of fluid loss (thirst, absent tears), so classifying it as 'None' (no dehydration) is incorrect.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment of dehydration in children based on WHO/IMNCI guidelines as background academic context rather than a clinical decision trigger.
Accurate assessment of dehydration is a critical nursing skill, as it determines the appropriate fluid management strategy (WHO Plan A, B, or C) and prevents progression to hypovolemic shock.
Nurses play a key role in administering ORS correctly, monitoring the child's response to therapy, and educating caregivers on home management and danger signs.
What if? If the child was also lethargic and drinking poorly, the classification would change to 'Severe Dehydration,' requiring immediate initiation of intravenous fluids (Plan C) instead of oral rehydration.

How to Approach the Question

First, identify the key clinical signs mentioned in the question stem: 'thirst present' and 'tears absent'.
Recall the standard classification of dehydration in children (e.g., WHO/IMNCI guidelines), which categorizes it into No, Some (Moderate), and Severe dehydration.
Systematically compare the given signs with the criteria for each category.
Note that 'thirst/drinks eagerly' and 'absent tears' are classic signs of 'Some Dehydration'.
Select the option that corresponds to 'Some Dehydration', which is 'Moderate'.

Concept Tested & Keywords

Concept Tested: Clinical assessment of dehydration in children based on WHO/IMNCI guidelines.
Stem keywords: Dehydration, child, diarrhoea, thirst present, tears absent
Lead-in keywords: is
Clinical cues: Thirst present: Indicates the body's compensatory mechanism to increase fluid intake is active.
Clinical cues: Tears absent: A specific and reliable sign of significant extracellular fluid depletion.

Qp1yRyjx5gQVsUwGL4o8PB

E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 311-313, 816-818

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 574-576