NORCET 6 mains-2024: The amount of ORS (Oral Rehydration Solution) to be given after each stool for children less than 24 months i…

NORCET 6 mains-2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 6 mains-2024

Explanation

According to WHO and IMNCI guidelines (Treatment Plan A), the recommended amount of ORS for a child under 24 months is 50–100 ml after each loose stool.
This specific volume is designed to replace fluid and electrolyte losses effectively, thereby preventing the onset of dehydration.
This approach is part of the home management strategy for diarrhea in children who do not show signs of dehydration.

Option A: This volume is too low and generally insufficient to replace the fluid lost in a typical diarrheal stool for a child under two years.
Option B: Allowing a child under 24 months to drink 'as wanted' is unreliable, as they cannot effectively communicate their fluid needs. This can lead to inadequate intake.
Option C: This volume is significantly too small and would be ineffective in preventing dehydration, as it would not come close to replacing the fluid lost.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain ORS administration guidelines for pediatric diarrhea (WHO/IMNCI Plan A) as background academic context rather than a clinical decision trigger.
A key nursing responsibility is educating caregivers on the '4 Rules of Home Treatment' for diarrhea: 1) Give extra fluids (ORS), 2) Continue feeding, 3) Give Zinc supplementation for 14 days, and 4) Know the danger signs for when to return to a health facility.
Proper caregiver education on how to mix and administer ORS is critical for treatment success and preventing complications like dehydration and malnutrition.
What if? If the child shows signs of 'some dehydration' (e.g., restless, irritable, sunken eyes, drinks eagerly), the management plan changes to Treatment Plan B. This requires administering a larger, calculated volume of ORS (approximately 75 ml/kg) over a 4-hour period, typically supervised at a health facility.

How to Approach the Question

First, identify the key parameters in the question: the patient's age ('less than 24 months') and the specific instruction needed ('amount of ORS... after each stool').
Recognize that 'after each stool' implies a strategy to prevent dehydration in a child who is not yet dehydrated (WHO Treatment Plan A).
Recall the standard WHO/IMNCI guidelines for ORS administration based on age.
Compare the options to the recalled guideline for the '< 2 years' age group.
Select the option that matches the recommended dosage of 50-100 ml.
Eliminate other options because they are either insufficient (10-30 ml, 40-55 ml) or for a different age group ('As wanted' for >10 years/adults).

Concept Tested & Keywords

Concept Tested: ORS administration guidelines for pediatric diarrhea (WHO/IMNCI Plan A)
Stem keywords: ORS, Oral Rehydration Solution, children, less than 24 months, after each stool
Lead-in keywords: amount
Clinical cues: age less than 24 months
Clinical cues: after each stool

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