What is the primary treatment for most cases of acute watery diarrhoea?

BTSC Staff Nurse 30July-2025

Medical Surgical Nursing

Easy

Appeared in: BTSC Staff Nurse 30July-2025

Explanation

Oral Rehydration Solution (ORS) is the first-line therapy for managing mild to moderate dehydration caused by acute watery diarrhoea.
The glucose in ORS facilitates the absorption of sodium and water in the small intestine, effectively replenishing lost fluids and electrolytes.
It is a safe, cost-effective, and life-saving intervention recommended globally by the WHO for all age groups.
The primary goal of treating acute watery diarrhoea is not to stop the diarrhoea itself, but to prevent and treat dehydration, which ORS accomplishes.

Option A: Intravenous (IV) fluids are an invasive treatment and not the primary choice for most cases of diarrhoea, which typically involve mild to moderate dehydration.
Option B: Most cases of acute watery diarrhoea are viral in origin (e.g., Rotavirus, Norovirus), and antibiotics are ineffective against viruses. Unnecessary use contributes to antibiotic resistance.
Option D: Antidiarrheal agents like loperamide work by slowing intestinal motility. This can be harmful in infectious diarrhoea as it may prolong the illness by retaining the pathogen in the gut.

Clinical Relevance

Nursing practice connection: Knowing Management of Acute Watery Diarrhoea helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role is to assess the patient's hydration status using clinical signs (skin turgor, sunken eyes, capillary refill, urine output) to determine the appropriate intervention.
Patient and family education is critical. Nurses must teach caregivers how to correctly mix and administer ORS (small, frequent sips) and to recognize danger signs that require immediate medical attention.
What if? If a child with diarrhoea becomes lethargic, has a very dry mouth, and is unable to drink ORS due to weakness, the nurse must recognize these signs of severe dehydration and escalate care immediately for the initiation of intravenous (IV) fluid therapy.

How to Approach the Question

First, identify the key terms in the question: 'primary treatment' and 'acute watery diarrhoea'. 'Primary' implies the first-line, most common approach.
Recall the main danger of diarrhoea: dehydration. The primary treatment must address this fundamental problem.
Evaluate the options based on this principle. Oral Rehydration Solution (ORS) is specifically designed to combat dehydration by replacing fluids and electrolytes.
Consider the other options. IV fluids are for severe cases, not 'most' cases. Antibiotics are for specific infections, not general watery diarrhoea. Antidiarrheals are often contraindicated.
Conclude that ORS is the safest and most appropriate primary treatment for the majority of patients.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 p. 1122-1124

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1791-1793