Question

• What is the pathophysiology of Kwashiorkor?
• Explain the manifestations of Kwashiorkor.
• What treatment and nursing care would be given, to a client with Kwashiorkor?

Answer 1

Kwashiorkor is a protein deficiency disease affecting mainly children.

Pathophysiology of kwashiorkor:

Decreased protein intake====> decreased synthesis of visceral proteins and digestive enzymes.

Inadequate digestive enzyme causes GIT upset, atrophy of mucosa lining leads to diarrhoea.

Diarrhoea leads to loss of electrolyte like potassium.

This decreased visceral proteins====> hypoalbuminemia

This hypoalbuminemia====> contribute to accumulation of extravascular fluid.It will cause edema.

There will be impaired synthesis of B-lipoptotein, leads to the development of fatty liver.

Manifestations of kwashiorkor:

#. Change in colour of skin and hair.

#. Fatigue and loss of muscle tone.

#. Diarrhea

#. Failure to gain weight

#. Edema of ankle and feet.

#. Irritability and lethargy.

#. Decreased immunity.

Treatment of kwashiorkor:

Treatment includes increase the intake of food rich in protein and calories.

Patient should be first provided with more calories in the form of fat, sugar and carbohydrates, then provide protein, vitamin and minerals.

Correct electrolyte deficiency caused by diarrhoea

Some children may develop with lactose intolerance,so try to avoid milk and milk products.

If children develop shock,they have to get medication for supporting blood pressure.

As kwashiorkor causes decreased immunity,children should be protected from other infections.

Nursing care of child with kwashiorkor:

Assess development status of the child as kwashiorkor affects child's growth and development.

Assess the child for skin,hair and musculoskeletal disorders.

Collect children's nutritional history about eating habits to plan for diet management

Encourage the child to take high calorie and protein rich food.

Re-start feeding the child with frequent monitoring of electrolyte.

Progressively increase nutrients,use small frequent feeding,

Ensure adequate hydration to the child.

Strictly monitor intake and out put.

Instruct family members regarding nutritional measures to be continued until child gain appropriate weight.