Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 19 of 160 Nutritional diseases Malnutrition is commonly defined as lack of necessary food substances, but in practice malnutrition includes both under-nutrition and over-nutrition. Over-nutrition is a caloric intake that surpasses the daily energy requirements. Under-nutrition is a caloric intake of nutrients insufficient to meet daily energy requirements. Some common causes of under nutrition are dysphasia and anorexia. Protein- calorie Malnutrition (PCM) is often seen in starving children of third world countries, and in clients with significant problem with long- term deficiencies in caloric intake such as cancer and chronic disease. Primary Nutritional Disease A primary nutritional disease occurs when nutrition is the cause of the disease. The most common are scurvy, rickets, and beriberi. • Scurvy: The primary cause of scurvy is insufficient intake of vitamin C (ascorbic acid). o Symptoms: Scurvy symptoms begin with appetite loss, poor weight gain, diarrhea, rapid breathing, fever, irritability, tenderness and discomfort in legs, swelling over long bones, bleeding (hemorrhaging), and feelings of paralysis. As the disease progresses, a scurvy victim may present bleeding of the gums, loosened teeth, petechial hemorrhage of the skin and mucous membranes, bleeding in the eye, protruding eye, costochondral beading (beading of the cartilage between joints), hyperkeratosis (a skin disorder), corkscrew hair, and sicca syndrome (an autoimmune disease affecting connective tissue). Infants with scurvy will become apprehensive, anxious, and progressively irritable. They often will assume the frog leg posture for comfort when struck with pseudo paralysis. It is common for infants with scurvy to present sub periosteal hemorrhage, a specific bleeding that occurs at the lower ends of the long bones. o Diagnosis: Physicians initially will conduct a physical exam, looking for symptoms described above. Actual vitamin C levels can be obtained by using laboratory tests that analyze serum ascorbic acid levels (or white blood cell ascorbic acid concentration). Sometimes, radiological procedures are ordered for diagnostic purposes and to see what damage scurvy has already done. o Treatment: Scurvy is treated by providing the patient with vitamin C, administered either orally or via injection. Orange juice usually functions as an effective dietary remedy, but specific vitamin supplements are also known to be effective. Scurvy can be prevented by consuming enough vitamin C, either in the diet or as a supplement. Foods that contain vitamin C include: oranges, lemons, guava, kiwifruit, papaya, tomatoes, strawberries, carrots, broccoli, potatoes, cabbage, spinach, paprika, liver, oysters, and bell peppers. • Rickets: Rickets is most commonly caused by a vitamin D deficiency. o Symptoms: Signs and symptoms of rickets are bone pain or tenderness, dental problems, muscle weakness (aka-rickety myopathy, floppy baby syndrome or slinky baby), increased tendency for fractures (especially greenstick fractures) and skeletal deformity. o Diagnosis: The predominant cause is a vitamin D deficiency, but lack of adequate