Health Issues and Risks That Are Relevant to the Child
Undernutrition directly causes micronutrient deficiencies such as iron, vitamins A and D, folate, thiamine, and zinc. As a result, the child has an increased risk of developing nutritional anemia, night blindness, rickets, poor growth, and poor muscle activity, deteriorating their quality of life (Dipasquale et al., 2020). Additionally, fat and muscle mass depletion is due to reductive adaptation, where the child’s energy source is drawn from muscle, adipose, and bone. This results in reduced muscle function, fractures,and alteration in electrolyte balance.
Malnutrition may also affect the child’s cardiac function. Reductive adaptation causes cardiac muscle loss, resulting in decreased cardiac output and low blood pressure (De Sanctis et al., 2021). In addition, there is micronutrient deficiency and alterations in electrolyte balance which alter cardiac function. Decreased cardiac output leads to poor tissue perfusion, causing delayed wound healing. Reduced cardiac output and electrolyte imbalance may further worsen renal function by reducing renal blood flow and glomerular filtration rate.
Malnutrition affects gastrointestinal function, resulting in changes in pancreatic exocrine function, intestinal blood flow, villous architecture, and intestinal permeability, reducing the gut’s ability to absorb nutrients. In addition, the colon loses its ability to reabsorb water and electrolytes, resulting in diarrhea and worsened nutritional losses. The liver is also affected, and all its metabolic, synthesis, detoxification, and excretory function are affected resulting in hypoglycemia and accumulation of toxic metabolites (Schuetz et al., 2021). Immune function is also affected, increasing the risk of infection due to innate and adaptive immunity predisposing the child to respiratory, gastrointestinal, and urinary tract infections (Fontane et al., 2023). However, due to a failed immune system, most signs of infection, such as fever, may be absent.
Additional Information I Would Need to Further Assess Her Weight-Related Health
Undernutrition causes multisystem organ dysfunction. It is thus crucial to inquire whether the parents have noticed whether the child has had persistent vomiting or diarrhea. In addition, it is crucial to note any temperature changes, signs of shock, open skin lesions, edema, dehydration, tachypnea, and cyanosis (Brits et al., 2020). I may also need to look at her growth curve to check for any previous abnormalities and compare her growth versus the standard. I would also need a mid-upper arm circumference, Z-scores, and basal metabolic index. Laboratory tests are also essential for assessing malnutrition(Kabashneh et al., 2020). Necessary tests include complete blood count, hemogram, septic screen, liver and renal function tests, urinalysis, protein tests, urea-electrolytes and creatinine test, and tests for inflammatory markers. While performing a physical exam, I would need to look for any hair, nail, eye, skin, and mouth changes, such as fissures, cheilitis, and stomatitis (De Sanctis et al., 2021). I would also need to check for distended abdomen and hepatomegaly, observe for behavioral changes, and assess for development.
Risks and Further Information I Would Need to Gain a Full Understanding of the Child’s Health
Undernutrition occurs when one does not have an adequate diet or has malabsorption conditions. In assessment of the child’s weight-related health condition, it is essential to take note of the quality and quantity of the food she takes through a food diary history (Vassilakau, 2021). Inadequate diet and non-nutritious foods like processed juices predispose to micro and macronutrient deficiencies. Additionally, it is crucial to inquire whether she has any food allergies, fads, restrictions, and preferences, as they may predispose her to undernutrition.
It is crucial to ask whether the child has any underlying medical condition that may affect the ability to swallow, digest, or absorb foods. It is crucial to assess whether they have nausea and anorexia or are taking medications that may be causing both. Additionally, it is vital to rule out any cause of dysphagia, which can limit oral intake of food (Schuetz et al., 2021). Medical conditions such as chronic diarrhea or childhood malignancies have been linked to undernutrition due to increased metabolic needs. One may also need to inquire about malabsorption disorders such as celiac disease and inflammatory bowel disease that may cause excessive nutritional loss.
Undernutrition can also be caused due to mental health conditions and feeding environments. It is thus crucial to screen for eating disorders such as anorexia and bulimia that may have an impact on the child, considering that the
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