Poor indicator to response during treatment of malnutirion includes -
Ans is 'b' i.e., Presence of edema on day 10 Guidelines on Hospital based management of severely malnourished children o The curent guidelines recommended in-patient (hospital) management of all severely malnourished children are divided into ten essential steps: Treat/prevent hypoglycemia Treat/prevent hypothermia Treat/prevent dehydration Correct electrolyte imbalance Treat/prevent infection Correct micronutrient deficiencies Sta cautious feeding Achieve catch-up growth Provide sensory stimulation and emotional suppo Prepare for follow-up after recovery. Monitoring progress during treatment o Good weight gain is >10 g/kg/day and indicates a good response. It is recommended to continue with the same treatment. o Moderate weight gain is 5-10 g/kg/day; food intake should be checked and the children should be screened for systemic infection. Poor weight gain is < 5g/kg/day, screening for inadequate feeding, untreated infection, tuberculosis and psychological problems is recommended. Indicators of failure to respond Primary failure to respond is indicated by: Failure to regain appetite by day 4. Failure to sta losing edema by day 4. o Presence of edema on day 10. Failure to gain at least 5.g/kg/day by day 10. o Secondary failure to respond is indicated by failure to gain at least 5g/kg/day for 3 consecutive days during the rehabilitation phase. Criteria for discharge o Severely malnourished children are ready for discharge when the following criteria have been fulfilled: (i) Absence of infection. (ii) The child is eating at least 120-130 cal/kg/day and receiving adequate micronutrients. (iii) There is consistent weight gain (of at least 5 g/kg/day for 3 consecutive days) on exclusive oral feeding. (iv) WFH is 90% of NCHS median; The child is still likely to have a low weight-for-age because of stunting. (v) Absence of edema. (vi) Completed immunization appropriate for age. Caretakers are sensitized to home care.
Failure to gain appetite by day 10
Presence of edema on day 10
Failure to gain at least 5 g/kg/day by day 4
All