Which of the following should be given first in a severely malnourished child ?
**Core Concept**
In severely malnourished children, the goal is to restore fluid balance, electrolytes, and glucose levels before initiating nutritional supplements. This is crucial to prevent complications such as refeeding syndrome.
**Why the Correct Answer is Right**
The first step in managing a severely malnourished child is to administer intravenous (IV) fluids, specifically 0.9% normal saline, to correct dehydration and electrolyte imbalances. This is followed by the administration of 10% dextrose to provide glucose and prevent hypoglycemia. The Ringer's lactate solution can also be used in some cases, but it is not the first choice due to its potential to cause hyperkalemia in severely malnourished children.
**Why Each Wrong Option is Incorrect**
**Option A:** Oral rehydration therapy (ORT) is not the first line of treatment in severely malnourished children as they may not be able to tolerate oral intake.
**Option B:** High-calorie supplements should not be initiated immediately in severely malnourished children as it can lead to refeeding syndrome.
**Option C:** Glucose-containing IV fluids should be given first to prevent hypoglycemia and provide energy for cellular functions.
**Clinical Pearl / High-Yield Fact**
It is essential to assess the child's hydration status, electrolyte levels, and glucose levels before initiating nutritional supplements to prevent refeeding syndrome and other complications.
**Correct Answer:** C.