Physical Examination and Treatment for Marasmus

Assessment for Marasmus

The assessment consists of: initial assessment and follow-up assessment.

1. Initial assessment (for emergencies):

• Incidence of sunken eyes that had just appeared
• The duration and frequency of diarrhea and vomiting as well as the appearance of materials vomiting and diarrhea (watery / blood / mucus)
• When was the last urination
• Since when did the hands and feet felt cold.

When found on the above, it is likely the child is dehydrated and / or shock, and must be addressed immediately.

2. Follow-up assessment (to find the causes and subsequent management of the plan, carried out after the emergency is handled):

• Diet / eating habits before the illness
• History of breastfeeding
• Intake of foods and beverages consumed the last few days
• Loss of appetite
• Contact with measles or tuberculosis patients
• Ever measles in the last 3 months
• Chronic cough
• Incidence and cause of death of siblings
• Birth weight
• History of growth and development: sitting, standing, talking, etc.
• Immunization history
• Does were weighed every month
• Family environment (to understand the social background of the child)
• Known or suspected HIV infection

Physical Examination for Marasmus


Is the child looked very thin,


Is there edema on both back legs.

• Determine the nutritional status.
• Signs of dehydration: thirst appears, sunken eyes, poor turgor (be careful to determine the status of dehydration).
• Are there any signs of shock (cold hands, capillary refill time is slow, weak and rapid pulse), decreased consciousness.
• Fever (axillary temperature ≥ 37.5 ° C) or hypothermia (axillary temperature <35.5 ° C). The frequency and type of respiratory: pneumonia or heart failure Very pale Enlarged liver and jaundice Is there abdominal distention, bowel sounds fell / rose, a sign of ascites, or a sound like a blow on the water surface (abdominal splash)

Treatment for Marasmus

1. Sign of vitamin A deficiency on the eye:

• Conjunctival or corneal dryness,
• Bitot spots; Corneal ulcers;
• Keratomalasia
  

2. Ulcers in the mouth --> Focus infections: ear, throat, lungs, skinSkin

3. Lesions in kwashiorkor:

• hypo / hyperpigmentation;
• desquamation;
• ulceration (legs, thighs, genitals, groin, behind the ears);
• exudative lesions (resembling severe burns) often with secondary infections (including yeast).

4. Display stools (consistency, blood, mucus).

5. Signs and symptoms of HIV infection.

Note:

• Children with vitamin A deficiency is often photophobia. Important to examine the eye carefully to avoid tearing of the cornea.
• Laboratory examinations and hemoglobin or hematocrit, if the kids get very pale.

Marasmus - Pathophysiology, Causes, Signs and Symptoms

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Marasmus - Pathophysiology, Causes, Signs and Symptoms

Marasmus is a condition caused by malnutrition due to low energy consumption of calories and protein in the daily diet resulting in an inadequate intake of calories needed by the body.

Causes of Marasmus

According to Behrman (1999: 122) causes of marasmus are:

1. Inadequate caloric intake, as a result of deficiencies in the arrangement of food.
2. Food habits are not feasible, as contained in the parent-child relationship is disrupted or as a result of metabolic disorders or congenital malformations.
3. Each body system disorder that can lead to severe malnutrition.
4. Caused by the negative influence of socioeconomic factors and cultural events that contribute to general malnutrition, negative nitrogen balance can be caused by chronic diarrhea, malabsorption of protein, urine protein loss (neprofit syndrome), chronic infections, burns and heart disease.

Signs and Symptoms of Marasmus

1. Child's whiny, cranky, and not excited.
2. Diarrhea.
3. Eyes large and deep.
4. Acral cyanosis and looks cool.
5. Face as parents.
6. Impaired growth and development.
7. Occur begi ass, because there is muscle atrophy.
8. Fatty tissue under the skin will disappear, the skin wrinkles and poor skin turgor ..
9. Belly bulge or concave with a clear picture of the intestine.
10. Slow pulse and decreased basal metabolism.
11. Superficial veins are more apparent.
12. Large fontanel sunken.
13. Cheekbones and chin stand out.
14. Anorexia.
15. Frequent night waking.

Pathophysiology of Marasmus

Growth with less or stop muscle atrophy and lose fat under the skin. At first this is prosesn physiological abnormalities. For the survival of tissue the body requires energy, but does not come alone and protein reserves are used also to meet the energy needs. Tissue destruction in calorie deficiency not only help meet energy needs, but also to allow the synthesis of glucose and other metabolites such as amino acids essential for the homeostatic component. Therefore, in severe marasmus are sometimes still found a normal amino acid, so that the liver is still able to form enough albumin.

Physical Examination and Treatment for Marasmus

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