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Manutrition in children is major problems

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1slide share malnutrition modify

  1. 1. MALNUTRITION INCHILDREN Prepared By Lamiaa Pediatric Nursing
  2. 2. MALNUTRITION INCHILDRENOBJECTIVES To understand meaning of Malnutrition To understand the etiology of Malnutrition. To list the Causes KWO and Marsmus inchildren. Diagnose Malnutrition To identify the treatment and prevention forKWO and marasmus.2
  3. 3. HUMAN NUTRITIONNutrients are substances that arecrucial for human life, growth &well-being.•Macronutrients (carbohydrates,lipids, proteins & water)•Micronutrients are trace elements& vitamins, which are essential formetabolic processes.
  4. 4. MALNUTRITIONMALNUTRITIONimproper and / or inadequatefood intakeinadequate absorptionof foodDeficient supply of foodpoor dietary habitsfood faddismemotional factors metabolic abnormalitiesdiseases
  5. 5. WHO IS AFFECTED BYMALNUTRITION? Infants, children, the elderly, prisoners) Mentally disabled or ill because they are notaware of what to eat. People who are suffering from tuberculosis, eating disorders, HIV/AIDS, cancer, or who have undergone surgical procedures aresusceptible to interferences with appetite orfood uptake which can lead to malnutrition.
  6. 6. MALNUTRITION Malnutrition: Is defined as pathological stateresulting from relative or absolute deficiency ofone or more essentialnutrients( Malnutrition…..Kwashiorkor)Kwashiorkor :is a form of malnutrition caused byinadequate Protein intake in the presence of fairto good energy (total calories) intake. Malnutrition is common in children between ageof above one year 2 years Under nutrition It is the outcome of insufficientfood. It is caused primarily by an inadequateintake of dietary or food energy. Under nutrition…….Marasmus
  7. 7. DEFINITIONS OF MALNUTRITION Kwashiorkor: protein deficiency Marasmus: energy deficiency Marasmic/ Kwashiorkor: combination of chronicenergy deficiency and chronic or acute proteindeficiency
  8. 8. PROTEIN MALNUTRITIONPROTEIN MALNUTRITION))PCM or PEM, Protein-Calorie (Energy) MalnutritionPCM or PEM, Protein-Calorie (Energy) Malnutrition,,KwashiorkorKwashiorkor((
  9. 9.  Clinical syndrome resultedfrom a severe deficiency ofprotein & inadequate caloricintakeKWASHIORKORKWASHIORKOR
  10. 10. FACTORS THAT EFFECTPROTEIN NEED1) Age -- child needs more protein2) Size -- bigger person needs moreprotein.3) Sex -- male needs more than female.4) Danger -- increases need due tostress hormones5) Exercise -- increases need foralanine6) Fever -- increases need7) Growth -- increases need
  11. 11.  Deficient intake of protein Impaired absorption of protein, as inchronic diarrheal states Abnormal losses of protein in proteinuria Infection(TB) Hemorrhage or burns Failure of protein synthesis, as in chronicliver diseasesETIOLOGYETIOLOGY
  12. 12. DIAGNOSIS OF KWO The physical examination may show anenlarged liver (hepatomegaly) and generalswelling. Tests may include: Arterial Blood Gas. Complete Blood Count CBC Creatinine Clearance. Serum Creatinine. Serum Potassium. Total Protein Level. Urinanalysis
  13. 13. CLINICALMANIFESTATIONConstant or cardinalmanifestationUsual manifestation
  14. 14. CONSTANT OR CARDINALMANIFESTATION 1-Growth Retardation Weight is diminished Retarded liner growth length HC may be affected Bone age may be retarded 2-Oedema Hypoprotenemia Start in lower part and become generalized Usually soft and pitting edema The cheek become pale and waxy
  15. 15. CONSTANT OR CARDINALMANIFESTATION3-Muscle WastingDisturbed muscles fat ratioGeneralized muscle waste determined bymid arm circumference which isdiminishedThe children is weak hypotonicUnable to stand or walk4- PSYCHOMOTOR CHANGESApathyLack interest in surroundingLook sad and never smileHis cry is weak(Moon Face)
  16. 16. USUALLY PRESENTSIGNS1-HAIR CHANGES sparse, hair lose its color become reddish orgrayish2-Gastrointestinal manifestationAnorexia-Vomiting- Diarrhea3-SKIN DEPIGMENTATION (dermatosis-rash appear in the back of thighand axillary Hyopigmentation lead to skin damage4-MOON FACE5-Hepatomegalycaused6-Poor resistance and liability to infection
  18. 18. COMPLICATIONS1) DehydrationSkin infection2) Hemorrhage3) Heart failure4) Chest infection5) Permanent mental and physicaldisabilityCause of death KWO1. Recurrent infection2. Hypoglycemia3. Heart failure
  19. 19. MANAGEMENT OF KWO Getting more calories and protein will correctkwashiorkor. Treatment depends on the severity of thecondition. children who are in shock needimmediate treatment to restore blood volume andmaintain blood pressure. Calories are given first in the formof carbohydrates, simple sugars, and fats. Vitamins and mineral supplements areessential. Food must be reintroduced slowly.Carbohydrates are given first to supply energy,followed by protein foods.
  20. 20. MARASMUS The term marasmus is derived from theGreek marasmos, which means wasting orStarvation.
  21. 21. MARASMUSMARASMUS(Infantile Atrophy, energy-deficiency(Infantile Atrophy, energy-deficiencyor energy-protein deficiency)or energy-protein deficiency)-LACK OF CALORIES
  22. 22. MARASMUS Definition It is a clinical;syndrome resulting mainlyunder nutrition due to severdeficiency of protein,fat,andCarbohydrates inadequatecalorie supply(starvation)
  23. 23. ETIOLOGYETIOLOGY OF MARASMUSOF MARASMUS Dietic causes Scanty milk Improper weaning and overdiluted formula Feeding difficulties as cleft lip Vomiting, diarrheas, Anorexia Stomatitis Malabsorption syndrome Cardiac abnormality Prematurity
  24. 24. CLINICAL FEATURES OFMARASMUScharacterized by: Sever wasting weight less than 60% Loss of subcutaneous fat Severe wasting of muscle & s/c fats Severe growth retardation Child looks older(old man) than hisage or senile face. No edema or hair changes Alert but miserable &Hungry Temperature is usually sub-normal
  25. 25.  Emaciation Skin wrinkled Subcutaneous fat disappears fromabdomen first,Buttocks, thenextremities, and finally face
  26. 26. MARASMUS A thin “old man “face or Monkey Facies• “ Baggy pants “ (the loose skin of the buttockshanging down).• There is no oedema (swelling that pits onpressure) of the lower extremities.
  27. 27. INVESTIGATIONSFOR PEM Full blood counts Blood glucose profile Septic screening Stool & urine for parasites & germs Electrolytes, Ca, Ph &, serum proteins CXR & Mantoux test
  28. 28. MANAGEMENT OF MARASMUS Constant monitoring. Patients with marasmus should be isolated fromother patients, especially children withinfections. Treatment areas should be as warm as possible,and bathing should be avoided to limithypothermia. Therefore, the hospital structure is best adaptedfor the treatment of severe malnutrition.
  29. 29. MANAGEMENT OF MARASMUS In cases of shock, intravenous (IV) rehydration isrecommended using a Ringer-lactate solutionwith 5% dextrose or a mixture of 0.9% sodiumchloride with 5% dextrose. The following rules should be implemented inthe initial phase of rehydration: (1)Use an nasogastric (NG) tube; (2)Continue breastfeeding, except in case ofshock or coma; and (3) Start other food after 3-4 hours ofrehydration
  30. 30. NURSING DIAGNOSIS FORMARASMUS Alteration in nutrition less than body requirementsrelated to inadequate food intake (decreased appetite Impaired skin integrity related to impaired nutritional /metabolic status• High risk of infection associated with damage to thebodys defense• Lack of knowledge related to its lack of information Changes in growth and development associated withphysical melemahnyakemampuan and dependencesecondary to caloric intake or inadequate nutrition. Intolerance activities associated withimpaired oxygen transport systemsecondary to malnutrition. (
  31. 31. NURSING MANAGMENT Lack of knowledge related to its lack ofinformation to increased knowledge ofpatients and. Determine the level ofknowledge of the patients parents.  Assess dietary needs and answer questions asindicated. Encourage the consumption of foodshigh in fiber and fluid intake is adequate.