MALNUTRITION

Submitted to :- Submitted by :-
MISS. BARSARANI BEHERA, SASMITA HARIPAL
SISTER TUTOR OF BSC NURSING 2ND YEAR
SAMBALPUR NURSING COLLEGE, ROLL NO - 46
SAMBALPUR
 CONTENT
• Introduction
• Definition
• Types
• Epidemiological tried
• Causes
• Mode of transmission
• Clinical manifestation
• Sign and symptoms
• Diagnosis
• Treatment
• Prevention
• Role of Nurse
• Summary
• Conclusion
• Bibliography
 INTRODUCTION
❖ Malnutrition is defined as imbalance between the body’s need and the intake of nutrients, which can lead
to nutritional disorders.
❖ So intake of nutrients in proper amount is needed.

Definition
The world health organization (WHO) defines malnutrition as
“ the cellular imbalance between the supply of nutrients and energy and the body’s demand for them to
ensure growth, maintenance, and specific functions.”
 Types of Malnutrition
❖ These are two forms of malnutrition

1. Overnutrition
2. Undernutrition
❖ Both conditions can come with serious health consequences.

1. Overnutrition
➢ Overnutrition happens when you take in more of a nutrient then you need
every day.
➢ While many people think malnutrition means a lack of nutrients,
overconsumption is also considered malnutrition because it has negative
health consequences.

Types of overnutrition
It was formed in two types
I. Energy overnutrition
II. Micronutrient overnutrition
I. Energy overnutrition
➢ Consuming too much energy, which also means calories, will cause you to gain weight over time unless you
increase your physical activity.

➢ Energy overnutrition is common in developed countries.

➢ Sometimes
➢ , people with this type of overnutrition may also experience micronutrient undernutrition if their foods are
high in calories but low in micronutrients.

II. Micronutrient overnutrition

➢ Micronutrient overnutrition occurs when you consume too much of any certain nutrients.
➢ It’s possible to get too much of most vitamins or minerals, but usually, this happens when you
take megadoses of dietary supplements.
➢ Micronutrient overnutrition can cause acute poisoning, such as taking too many iron pills at
once.
2. Under nutrition
➢ Undernutrition occurs when you don’t get enough of a nutrient or calories
in general.
➢ This can occur when you do not eat enough food or do not eat enough
nutrients foods or can occur from medical conditions that interfere with the
absorption of nutrients.

Types of Undernutrition
❖ There are two types of undernutrition

I. Energy undernutrition
II. Micronutrient undernutrition
I. Energy undernutrition
➢ Energy undernutrition, or protein energy malnutrition ( PEM ) , is the form of malnutrition that people
usually mean when they use the word ‘malnutrition’.
➢ Energy undernutrition is more common in underdeveloped countries.
➢ PEM is visible in children who are undernourished and suffer from weight loss.

➢ Underweight women with PEM frequently give birth to babies who are also underweight.
➢ Certain diseases, such as some types of cancer, can also result in undernutrition.

➢ There are two forms of PEM :-

a. Starvation ( marasmus )
b. Protein deficiency ( kwashiorkor )
a. Starvation ( marasmus )
➢ Starvation, sometimes called marasmus, is a severe form of malnutrition due to lack of total energy,
resulting in poor growth, infertility, the even death.

➢ The body breaks down its own tissues to survive, and the body becomes emaciated in appearance.

b. Protein deficiency ( kwashiorkor )

➢ A lack of protein can cause PEM, even though there is still some carbohydrate or fat in the diet. This
condition is called kwashiorkor.

➢ People with kwashiorkor have thin arms and bloated abdomens.

II. Micronutrient Undernutrition

❖ Micronutrient undernutrition means a deficiency in one or more vitamins or minerals.
❖ Vitamin or mineral deficiency occurs when the diet is out of balance, and it can happen whether or not
calorie intake is adequate.
❖ In some cases, the deficiency is due ton a chronic health condition such as pernicious anemia, which
results in a lack of vitamin B12, Chron’s disease, celiac disease, or infections.
 ❖ Symptoms usually don’t occur immediately, but problems arise over time.

❖ Malabsorption occurs when the digestive system cant break down the nutrients for
proper absorption. This can leads to micronutrient undernutrition.
❖ Malabsorption can sometimes be treated with dietary changes but may required
medical treatment.

Nutritional deficiency
➢ A nutritional deficiency occurs when the body doesn’t absorb or get from food the
necessary amount of a nutrient.
➢ Deficiencies can lead to a variety of health problems.
➢ These can include digestion problems, skin disorder,
Stunted or defective bone growth, and even dementia.
 Epidemiological tried
❖ There were 795 million undernourished people in the world in 2014, a decrease of 216 million since 1990,
despite the fact that the world already produces enough food to feed everyone 7 billion people and could
feed more than that 12 billion people.
❖ Reducing malnutrition is key part of sustainable development goal 2 (SDG2) “Zero hunger” with a
malnutrition target alongside reducing under nutrition and stunted child growth.
❖ According to the World Food Program (WFP) 135 million suffer from acute hunger, largely due to
manmade conflicts, climate changes, and economic downturns.

Year 1990 1995 2005 2008 2014 2018

Undernourished
people in the world 843 788 848 923 795 853
( millions)
 Year 1970 1980 1990 2005 2007 2014

Percentage of
people in the 37 % 28 % 20% 16% 17% 13%
developing
world who are
undernourished
 Causes
❖ Disease and infection

❖ Individual
❖ Cooking method
❖ Like & dislike

❖ Religion
❖ Puberty
❖ Lack of education
 Mode of Transmission
❖ It is known as disease of four F’s as it is transmit by food, finger, faces and flies. So the transmission is
person to person and hand to mouth. So, it occurs through ingestion of contaminated food or water.

❖ Flies and formites spread through faces of carriers and patients.

❖ Factor related to its occurrence are malnutrition resistance and poor sanitation.
 Clinical manifestation

➢ Diagnostic approach to anemia in adults

➢ Malnutrition in children in resource-limited countries: Clinical assessment

➢ Vitamin and mineral deficiencies in inflammatory bowel disease

➢ Indications for nutritional assessment in childhood
➢ Persistent diarrhea in children in resource-limited countries

➢ Nutritional assessment in chronic liver disease

➢ Noma (cancrum oris)
➢ Assessment and management of anorexia and cachexia in palliative care

➢ Rectal prolapse in children

 Signs and symptoms

❖ A lack of appetite or interest in food

❖ Tiredness and irritability
❖ Always feeling cold

❖ Depression
❖ Loss of fat, muscle mass, and body tissue
❖ Longer healing time for wounds

❖ A higher risk of complications after surgery

❖ A lack of growth and low body weight
❖ Irritability and anxiety
 Diagnosis

➢ Blood tests for general screening and monitoring

➢ Tests for specific nutrients, such as iron or vitamins
➢ Prealbumin tests, as malnutrition commonly affects levels of this protein.

➢ Albumin tests, which may indicate liver or kidney disease

 Treatment

❖ Ongoing screening and monitoring

❖ Makes a dietary plan, which might including taking supplements
❖ Treating specific symptoms, such as nausea
❖ Treating any infection that may be present
❖ Checking for any mouth or swallowing problems
❖ Suggesting alternative eating utensils
In severe cases, a person may need to :-
❖ Spend time in the hospital
❖ Gradually start taking in nutrients over a number of days
❖ Receive nutrients such as potassium and calcium intravenously
 Prevention of malnutrition

❖ Health education to mothers about good nutrition and food hygiene

❖ Immunization of children
❖ Growth monitoring on growth charts specially of all children under 3 years of age.

❖ Mass screening of high risk populations, using simple tools like weight for age.
❖ Good nutritional care, supplementary feedings and rehabilitation, counselling of mothers.
 Role of Nurse

➢ Helping the patient understand the importance of the diet and encouraging dietary compliance.
➢ Serving meal trays to patients in a prompt and positive manner.
➢ Assisting some patients with the eating process.

➢ Taking and recording patient weight.

➢ Recording patient intake.
➢ Observing clinical signs of poor nutrition and reporting them.

➢ Serving as a communication link.

 Summary

➢ Malnutrition is the result of not taking a balance diet.

➢ When too much food is taken in, it results in obesity which leads to disease like coronary heart disease and
diabetes.
➢ When too little food is taken, it results in starvation which leads to disorder like anorexia nervosa.
➢ Eating incorrect proportion of main nutrients results in protein-energy disorders, e.g. kwashiorkor and
marasmus.
➢ Kwashiorkor happens in children that eat more carbohydrates than protein and marasmus occurs when
more protein is taken in than carbohydrates.
➢ Vitamins and minerals are needed in small amounts for proper body function.

➢ Vitamin C is needed to help heal wounds. Vitamin D is needed to maintain healthy bones and teeth.
➢ A lack of calcium leads to brittle bones and iron leads to anaemia.
 Conclusion

➢ Malnutrition is an barrier to development, and its presence indicates that basic physiological needs have
not been met.

➢ What is observed as malnutrition is not only the result of insufficient or inappropriate food , but also a
consequence of other conditions, such as poor water supply and sanitation and a high prevalence of
disease.
 Bibliography

❖ A text book of Community Health Nursing – 1 by NEELAM KUMARI

❖ And some are collected from slide share