PEM Flashcards
(31 cards)
PEM refers to
form of malnutrition which is defined in a range of Pathological conditions arising from coincident lack of protein and/or energy in varying proportion
PEM is measured in terms of
underweight - low weight for age
stunting - low height for age
wasting - low weight for height
Different types of PEM
Kwashiorkar
Marasmic Kwashiorkar
Marasmus
Nutritional Dwarfing
Under weight child
Kwashiorkar is also known as __
edematous malnutrition
becus of its association with edema (fluid retention)
Symptoms of Kwashiorkar
FADADFASCA
failure to thrive
anorexia
diarrhea
apathy
dermatosis
flaky paint appearance
Angular stomatitis
Sparse soft thin hair
cheliosis
anemia
Symptoms of Marasmus
FIFAD the ww cmd
failure to thrive
irritability
fretfullness
apathy
diarrhea
the temperature is subnormal
watery diarrhea and acid stools
weak muscle and atrophy
child is shrunk and there is little to no subcutaneous fat
many are hungry but some may be anorexic
dehydration
Symptoms of marasmic kwashiorkar
mixture of some features of both marasmus and kwashiorkar
Nutritional dwarfing
as an adaptation to prolonged insufficieny of food - energy and protein which is marked by retardation of growth
the underweight child has a risk of
gastroenteritis and respiratory infections
Energy requirement in pem
-child should be given 150-200kcal/weight/day for existing weight
-child below 2 years 200kcal/weight/day
-malted cereals to increase calorie density
-50% of total calorie from carbohydrates
Energy requirement in pem
-child should be given 150-200kcal/weight/day for existing weight
-child below 2 years 200kcal/weight/day
-malted cereals to increase calorie densit
___ to be given to increase calorie density in pem
malted cereals
Protein requirements in pem
5g/weight/day
10% of calorie from protein
high bv protein
fat requirements in pem
40% of total cal from fats
sfa’s better tolerated
butter
milk
coconut oil
treatment of pem in 3 stages
resolving life threatening condition
restoring nutritional status without disrupting homeostasis
ensuring nutritional rehabilitation
criteria for improvement of pem
disappearance of mental apathy - 4-5d
disappearance of edema - 7-10 days
weight gain - 3-4 weeks
rise in serum albumin level in 2 weeks
hospital treatment
hypothermia
child must be kept warm and practiced bedding in with mother
hospital treatment
hypoglycemia
10% dextrose,4ml/kg
septicaemia/infection
broad spectrum antibiotic, crystalline penicillin or ampicillin with aminoglycoside
Staphylococcus infection should be treated
in children with diarrhea if no dehydration
half to 1 glass ors
in mild to moderate dehydration
70ml/kg ors in 4 hr sip by sip or as intra gastric dip
severe dehydration
100ml/kg sodium saline/ringer lactate in 3-6 hrs
in oedematous children
70ml/kg given as slow ration
half the calculated fluid can be sodium saline or RL and rest 10% glucose
potassium supplement
2-4mEq/kg/d continued for 1-2 weeks in kwashiorkar
fruit juice
