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