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Inpatient Monitoring & Problem Solving for Severe Acute Malnutrition — Checklist

Hard 16 items · 1 hour
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testuser Published 3 weeks ago
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This checklist helps clinical staff and caregivers monitor inpatients with severe acute malnutrition and take practical steps when problems arise. Use it for daily bedside checks, feeding supervision, and early escalation of complications. Inspired by World Health Organization guidelines. Always consult a qualified healthcare professional.

Inspired by World Health Organization (WHO) guidelines. Always consult a qualified healthcare professional where applicable.

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  1. Check for danger signs (severe lethargy, convulsions, respiratory distress) — Look for conditions that need immediate emergency action.
  2. Measure and record weight and oedema status — Use the same scale daily; note pitting oedema and symmetry.
  3. Assess and document vital signs (temperature, pulse, respiratory rate) — Record values on the chart and compare to prior readings.
  4. Test blood glucose and treat hypoglycemia if low — Check immediately on admission and with any low-consciousness episode.
  5. Start or adjust therapeutic feeding plan based on weight — Calculate feed volumes and types using current weight.
  6. Verify feeding volume and schedule for each meal — Confirm prescribed ml per feed and feeding times match plan.
  7. Observe feeding tolerance and document vomiting or diarrhoea — Note signs of intolerance and time since feed started.
  8. Monitor fluid balance and signs of dehydration — Track intake/output, skin turgor, and urine output.
  9. Review and treat infections promptly — Start antibiotics when clinical assessment indicates infection.
  10. Monitor for hypothermia and keep patient warm — Provide blankets or skin-to-skin and avoid cool surfaces.
  11. Check electrolyte and micronutrient corrections — Ensure potassium, zinc, vitamin A, and other supplements are given per plan.
  12. Order or review relevant laboratory tests (CBC, electrolytes) — Request labs to guide treatment when indicated.
  13. Investigate causes of poor or no weight gain and adjust plan — Check feeding technique, intolerance, intercurrent illness, or missed feeds.
  14. Escalate care to a senior clinician for persistent complications — Request review if problems continue despite adjustments.
  15. Communicate care plan and feeding instructions to caregiver — Explain schedule, warning signs, and how to help at bedside.
  16. Record daily progress and review discharge readiness — Track weight trend, clinical stability, and milestone criteria.
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