The severely malnourished child is given __________
Correct Answer: Dextrose
Description: Prevent/treat hypoglycemia Prevent/treat hypothermia Treat/prevent dehydration ,Correct imbalance of electrolytes : Treat infections Correct deficiencies of micronutrients, Sta cautious feeding : *Red cell mass is reduced, releasing iron which requires glucose and amino acids to be conveed to ferritin, increasing the risk of hypoglycemia and amino acid imbalances. If conversion to ferritin is incomplete, unbound iron promotes pathogen growth and formation of free radicals. *Micronutrient deficiencies limit the body's ability to deactivate free radicals, which cause cell damage. Edema and hair/skin changes are outward signs of cell damage. When prescribing treatment it is essential to take these changes in function into account, otherwise organs and systems will be overwhelmed and death will rapidly ensue. Principles of Treatment Figure 46-6 shows the 10 steps of treatment, which are separated into 2 phases referred to as stabilization and rehabilitation. These steps apply to all clinical forms and all geographic locations, including Noh America and Europe. The aim of the stabilization phase is to repair cellular function, correct fluid and electrolyte imbalance, restore homeostasis, and prevent death from the interlinked triad of hypoglycemia, hypothermia, and infection. The aim of the rehabilitation phase is to restore wasted tissues (i.e., catch-up growth). It is essential that treatment proceeds in an ordered progression and that the metabolic machinery is repaired before any attempt is made to promote weight gain. Pushing ahead too quickly risks inducing the potentially fatal "refeeding syndrome." Caregivers bring children to health facilities because of illness, rarely because of their malnutrition. A common mistake among healthcare providers is to focus on the illness and treat as for a well-nourished child. This approach ignores the deranged metabolism in malnourished children and can be fatal. Ref.nelson 20th edition pg 302 nutrition chapter
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