Which of the following is used for grading protein energy malnutrition?

Appeared in: KPSC Staff Nurse - 2018

Explanation

The Gomez scale is specifically designed to classify the severity of Protein-Energy Malnutrition (PEM) in children.
It uses the weight-for-age percentage as its primary metric, comparing the child's current weight to the 50th percentile standard for their age.
The system categorizes malnutrition into three grades of severity (Mild, Moderate, Severe), which helps in standardizing diagnosis and planning interventions.
It is a simple and effective tool for nutritional surveys and clinical screening in community settings.

Option A: Ballard's scale assesses a newborn's gestational age and maturity, not their nutritional status or degree of malnutrition.
Option C: Bishop scoring is an obstetrical tool used to predict the likelihood of a successful labor induction. It has no application in pediatric nutritional assessment.
Option D: Kramer's rule is used for the clinical assessment of neonatal jaundice. It estimates serum bilirubin levels based on how far down the body the yellow discoloration has spread.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Protein-Energy Malnutrition (PEM) as background academic context rather than a clinical decision trigger.
Nurses use the Gomez classification in pediatric and community health settings for rapid screening of malnutrition, allowing for early intervention.
Accurate classification of malnutrition is crucial for determining the level of care required, from dietary counseling for mild cases to hospitalization and therapeutic feeding for severe cases.
What if a child presents with edema (swelling)? The Gomez classification, which is based only on weight, might underestimate the severity of malnutrition (as in kwashiorkor). In such cases, other classifications like the Wellcome classification, which accounts for edema, are more appropriate.

How to Approach the Question

First, identify the core concept of the question, which is the method for 'grading protein energy malnutrition' (PEM).
Review each option and recall its specific clinical application.
Gomez scale is related to pediatric nutrition.
Ballard's scale is for newborn gestational age.
Bishop score is for obstetrics (labor induction).
Kramer's rule is for neonatal jaundice.

Concept Tested & Keywords

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E6 Nutrition Monika Sharma 3e p. 222-224

E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 309-311

Practise the full KPSC Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.