Assessment of Dehydration in a Severely Malnourished Child

Children who are severely undernourished have different, unreliable signs and symptoms to assess the status of their hydration. For example, children with marasmus have poor skin elasticity even though they are not dehydrated, and sunken eyes are also not a reliable sign. Irritability in these children may be a sign of systemic infection rather than dehydration. The skin of children with kwashiorkor, on the other hand, may appear to be normal even if they are dehydrated. These children generally have apathetic attitudes. Undernourished children do not readily cry, so determining the absence of tears is also a challenge. Signs that prove to be more indicative to the status of a child's level of hydration include cool and clammy extremities, eagerness to drink, dry mouth and tongue, and a weak radial pulse.

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