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Showing posts with label Physical Examination and Treatment for Marasmus. Show all posts
Showing posts with label Physical Examination and Treatment for Marasmus. Show all posts

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

marasmus - Is the child looked very thin
Is the child looked very thin,

marasmus Is there edema on both back legs
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