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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

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