Marasmus a short description

This presentation describes different aspects related to Marasmus

1. MARASMUS
PREPARED BY:
Name
Kh. M. Nuruzzaman
R&D,Specialist

2. OUT LINES
•Introduction
•Definition
•Clinical features
•Etiology
•Complications
•Investigations
•Treatment & prevention of marasmus
•Nursing management

3. Marasmus is one of the 3 forms of serious protein-energy
malnutrition (PEM).
These forms of PEM represent a group of pathologic
conditions mainly in young children from developing
countries .
According to theWorld Health Organization (WHO), 49%
of the 10.4 million deaths occurring in children younger
than 5 years in developing countries are associated with
PEM.

4. WHAT IS MARASMUS?
The term Marasmus is derived from the Greek
Marasmos,which means wasting.
Itisaclinicalsyndromeresultingmainlyunder
nutritionduetoseverdeficiencyofprotein,fat,and
Carbohydratesinadequatecaloriesupply(starvation).

5. CLINICAL FEATURES

6. ETIOLOGY
•1-Dietary errors
•2 -Infection
•3-Gastroenteritis
•5-Congenital anomalies : Cardiac , Renal
,G.I.T
•6-Metabolic diseases.:Galactosemia ,
Fructose intolerance, Idiopathic
hypocalcaemia
•7-Prematurity
•8-Some cases of mental retardation
•9-Low socio economic status
•10-Endocrine causes

7. ASSESSMENT OF MARASMIC
CHILD/INFANT
•failuretothrive,lossofweight(weight<60%ofexpected)
•lossofsubcutaneousfat:measuredatmanypartsofthebody
accordingtothedegrees:-
•1stdegree:lossofs.cfatintheabd.wall
•2nddegree:lossofs.cfatoverthebuttockandthighs.
•3rddegree:s.cfatintheabd.wallandlimbsandface

8. ASSESSMENT OF MARASMIC
CHILD/INFANT(CONT.)
•Musclewasting
•G.I.Tdisturbancesasanorexiainadvancedcases,
hungry,constipationordiarrheaorstarvationdiarrhea
•liabilitytoinfection
•Hypovolemia
•Weakfeeblepulse,subnormaltemp,pulserate
•Senilefaceandpallor

9. COMPLICATIONS OF
MARASMUS
1.Intercurrentinfection:Bronchopneumonia
isthecauseofdeath
2.Gastroenteritis
3.Hypothermia
4.Hypoglycemia
5.jointdeformation
6.Severweakness
7.Organfailure

10. INVESTIGATIONS FOR
MARASMIC INFANT
•1.Blood analysis: (W.B.C
,Electrolytes Sugars, ketones, Plasma
proteins , normal or lowered )
•2. Urine analysis: culture, sugar,
ketones, ca, phosphate, amino acids
•3.Stool analysis for parasites
•4. X-rayfor chest and heart
•5. Tuberculin testfor T.B
•6. E.N.T examinationfor otitis media

11. TREATMENT
1-Prevention:-
•properdiet
•encouragebreastfeedinguptoweaning
•properweaning
•propervaccinationasmeasles,T.B.
•Educationregardingthecheapsources
ofbalanceddiet,familyplanning.
•Properfollowupofthegrowthrate
•Earlytreatmentofdefectsorassociated
diseases

12. TREATMENT
2 –Curative treatment:-
A-Proper dietary management:-
•Adequate balanced feeding. Teaching about nutritional needs ,
preparation of diet .
•If there is vomiting or anorexia, give IV fluids or naso gastric tube
feeding.
•Gradual increase the amount and concentration of formula
B –Treatment of the cause
D –Blood transfusion
E –Vitamins and minerals supplementation

13. WHAT’S BEST ?
B-BEGIN FEEDING
E-ENERGY DENSE FEEDING
S-STIMULATION OF EMOTIONAL
,SENSORIMOTOR DEVELOPMENT
T-TRANSFER TO HOME BASED DIET

14. COMMON NURSING
DIAGNOSES OF MARASMUS
1.Alterednutrition:Lessthanbodyrequirementsrelated
toknowledgedeficit,infection,physicaldeficit
2.Bodytemperaturealteration(hypothermia)
3.Impairedskinintegrity
4.Fluidvolumedeficitrelatedtodiarrhea
5.Highriskforinfection.

15. NURSING CARE
OF MARASMUS
1.Provide nutrition rich in essential nutrients
2.Give small amounts of foods limited in proteins, carbohydrates and
fats
3.Maintain body temperature
4.Provide periods of rest and appropriate activity and stimulation
5.Record intake and output
6.Weight daily
7.Change position frequently
8.Refer family to social worker for financial support
9.Education for parents about proper nutrition

16. MARASMIC KWASHIORKOR
Its a combination of caloric deficiency (marasmus )
and protein deficiency (KWO) .
Clinical picture
The clinical picture of this disease represents
manifestations from both diseases as:
•loss of subcutaneous fat as in marasmus
•Edema, hair and skin changes as in KWO but
there is no moon face.