nutritional deficiency disorder includes protein energy malnutrition,vitamin deficiences.

1. Nutritional
De
f
iciency
Disorders
Sushila School of Nursing
Presented by
Shalini Rana(Nursing Tutor)
CHILD HEALTH NURSING
1 Presentation 3 - 5 June 2023

2. 1.What is the meaning of malnutrition and its types?
• Malnutrition-it is de
f
ined as a pathological state resulting from a relative
or absolute de
f
iciency or excess of one or more essential nutrients.
• it consists of four form-a) undernutrition b) overnutrition c) imbalance
nutrition d) specif
f
ic de
f
iciency
• Important ones are- protein energy malnutrition , vitamin de
f
iciency
disorder, mineral de
f
iciency diseases.
2 Presentation 3 - 5 June 2023

3. Protein energy malnutrition(PEM)
• It is de
f
ined as a group of clinical conditions
that may results from protein de
f
iciency and
energy(calorie) de
f
iciencies.
• previously known as "Protein calorie
malnutrition(PCM)
Q2.What is the meaning of PEM?
3 Presentation 3 - 5 June 2023

4. Classi
f
ication of Protein Energy malnutrition(PEM)
• there are several classi
f
ication of PEM:-
• 1)Syndromal classi
f
ication
• 2)Gomez classi
f
ication
• 3)Welcome/international classi
f
ication
• 4)Classi
f
ication by Indian Academy of
pediatrics(IAP)
• 5)Jelliffe classi
f
ication
• 6)Waterlow classi
f
ication .etc,.
Q3.Explain di
ff
erent kinds of classi
f
ication of PEM.
4 Presentation 3 - 5 June 2023

5. Syndromal classi
f
ication
• 1) Kwashiorkor
• 2) Nutritional Marasmus
• 3) Pre kwashiorkar
• 4) Nutritional dwar
f
ing
Q4.Explain Di
ff
erent types of PEM as per syndromal classi
f
ication.
5 Presentation 3 - 5 June 2023

6. 6 Presentation 3 - 5 June 2023

7. Clinical features of PEM
• clinical features of PEM depend upon
severity and duration of nutritional
inadequacy,age of child,relative lack of
different food,presence or absence of
associated infections.
• kwashiorkor and marasmus are two extreme
forms of PEM.
• When the nutritional de
f
iciency exaggerates
with infections,the child may become
marasmic or may develop marasmus.
Q.What are the clinical features of PEM?
7 Presentation 3 - 5 June 2023

8. continued....
•
f
irst described by Dr.Cicely
williams
• mainly found in preschool
children.
• It occurs due to lack of protein
and calories in diet.
• Childhood infections like
ARI,diarrhoea,measles may
precipitate the disease.
kwashiorkor (type of PEM)
8 Presentation 3 - 5 June 2023

9. Clinical features of Kwashiorkor
• 1)marked growth retartdation
• 2)muscle wasting with retention of some
subcutaneous fat
• 3)
f
lag sign(alternate band of light and dark hair
color)
• 4)erythema
• 5)psychomotor changes -mental apathy,loss of
appetite
• 6)pitting edema
9 Presentation 3 - 5 June 2023

10. contd...
• 7)
f
laky paint dermatosis
• 8) skin infections
• 9)septicemia
• 10)vitamin de
f
iciencies ,etc.
10 Presentation 3 - 5 June 2023

11. • marasmus is aslo termed as "infantile atrophy".
• child looks like old person with shrivelled face.
• clinical features are-
• 1) marked stunting
• 2)marked growth retardation
• 3)absence of edema
• 4)dry skin,liver usually shrink
• 5)psychomotor changes-irritability,apathy
• 6)anemia
• 7)vitamin de
f
iciencies
• 8)diarrohea
• 9)vomiting
• 10)abdominal distention
Q5.clinical features of marasmus:-
11 Presentation 3 - 5 June 2023

12. Marasmic kwashiorkor
• it is de
f
ined as a condition where the child
manifested both the features of marasmus
and kwashiorkor.
• The presence of edema is essential for the
diagnosis and other features of kwashiorkor
may or may not be present.
Q6.De
f
ine marasmic kwashiorkaor.
12 Presentation 3 - 5 June 2023

13. Prekwashiorkor
• it is de
f
ined as a condition
when the child is having
features of kwashiorkor without
edema.
• if treated early,the child may be
protected from full blown
kwashiorkor.
Q7.De
f
ine prekwashiorkor.
13 Presentation 3 - 5 June 2023

14. Q8.What are the differences between Kwashiorkor and marasmus?
14 Presentation 3 - 5 June 2023

15. 15 Presentation 3 - 5 June 2023

16. Try to solve Q&A in
next slide
16 Presentation 3 - 5 June 2023

17. Q&A related to vitamins and minerals
17 Presentation 3 - 5 June 2023

18. -by shalini Rana(Nursing Tutor)
"Never stop learning,because life will never
stop teaching you"
18 Presentation 3 - 5 June 2023