Uttarakhand CHO - 2021
Pharmacology
Easy
Which of the following is not included in a WHO-ORS packet?
Appeared in: Uttarakhand CHO - 2021
Explanation
- Sodium Bicarbonate is not a component of the current WHO-recommended reduced-osmolarity Oral Rehydration Solution (ORS).
- It was present in the older formula but was replaced by Trisodium Citrate in 2004 to improve the stability and shelf-life of the packets.
- Trisodium citrate prevents the browning and caking that occurred when sodium bicarbonate reacted with glucose, and it also helps correct acidosis.
Why Other Options Were Wrong
- Option A: Sodium Chloride is a primary component of ORS, essential for replacing sodium lost during diarrhea and for facilitating water absorption in the intestines.
- Option B: Potassium Chloride is a crucial ingredient in ORS used to replenish potassium, an important electrolyte lost in large amounts in diarrheal stools, thereby preventing hypokalemia.
- Option D: Dextrose (a form of glucose) is a key ingredient. It facilitates the absorption of sodium and water from the gut via the sodium-glucose co-transport mechanism, which remains functional during diarrhea.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Composition of WHO-Oral Rehydration Solution (ORS) as background academic context rather than a clinical decision trigger.
- Correct preparation and administration of ORS is a cornerstone of managing dehydration from diarrhea, a simple intervention that significantly reduces mortality in children and adults.
- Nurses play a vital role in educating caregivers to dissolve the entire packet in exactly 1 liter of clean water and to use the solution within 24 hours, discarding any remainder to prevent bacterial contamination.
- What if? If a commercial ORS packet is unavailable, a homemade solution can be prepared as a temporary measure by mixing 6 level teaspoons of sugar and half a level teaspoon of salt in 1 liter of clean water. However, this lacks potassium and a base, so obtaining standard ORS remains a priority.
How to Approach the Question
- First, identify the core of the question, which is about the components of a WHO-ORS packet.
- Note the negative keyword 'not'. This signals that you are looking for the substance that is absent from the current standard formula.
- Recall the components of the current reduced-osmolarity ORS: Sodium Chloride, Potassium Chloride, Glucose (Dextrose), and Trisodium Citrate.
- Systematically compare the options to the known components. Sodium Chloride, Potassium Chloride, and Dextrose are all present in the formula.
- Identify Sodium Bicarbonate as the component that was part of an older formulation but has since been replaced. This makes it the correct answer to the 'not included' question.
Concept Tested & Keywords
- Concept Tested: Composition of WHO-Oral Rehydration Solution (ORS)
- Stem keywords: WHO-ORS packet, composition
- Lead-in keywords: not included
- Negative lead-in flag: The question asks which component is NOT included in a WHO-ORS packet.
Question ID
QXrPv03HW4G8O8yJPAj5uq
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 80-82
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 312-314
E6 Medicine Harrison 22e Part 1 p. 1369-1371
Practise the full Uttarakhand CHO - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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