Pediatric Bradley with Failure to Thrive - Case Study Example

Pediatric Case Discussion Case analysis and diagnosis 3 year old Bradley who lives in a heavy populated house was brought to the hospital for not gaining weight and also for runs. The boy received breast feeds only till ten months of age. On examination, Bradley has mild tachycardia and normal temperature, respiratory rate and blood pressure. His abdomen is distended. His weight, height and psychomotor skills are below 10th percentile. He is suspected to have worms because he vomited some and his perianal region examination reveals scratching signs. He also looks mildly dehydrated. Examination also reveals nits in hair and scabies of the skin. Bradley thus has multiple problems namely, failure to thrive, delayed psychomotor development, scabies, head louse infestation and worm infestation. He also has mild dehydration which needs to be corrected immediately. Discussion Failure to thrive in Bradley is most likely to be due to protein energy malnutrition. According to the World Health Organization or WHO (cited in Scheinfeld and Mokashi, 2008), malnutrition is the cellular imbalance between the supply of nutrients and energy and the bodys demand for them to ensure growth, maintenance, and specific functions." When malnutrition arises predominantly due to protein deficiency, the term protein-energy malnutrition is used. Marasmus, kwashiorkar and intermediate states of marasmus-kwashiorkar fall into this category of malnutrition. Bradley is affected with kwashiorkar. This condition typically appears at the time of weaning and hence is known as "sickness of the weaning" (Scheinfeld and Mokashi, 2008). Children with kwashiorkar present with weight loss or poor weight gain, slow linear growth, behavioral changes like irritability and apathy and psychomotor changes. Other symptoms include diarrhoea, edema, easy fatigability, nonhealing wounds, multisystemic impairment, distension of abdomen, cutaneous changes like dark and dry skin, depigmentation of hair and inflammatory bowel conditions. Clinical features in Bradley which point to Kwashiorkar are failure to thrive, distension of abdomen and psychomotor changes. Bradley will need proper evaluation and admission to hospital. One of the most important aspects of evaluation in Bradley is assessment of extent of dehydration. This is important for the purpose of calculation of rehydration fluids. Dehydration in children can be classified as mild, moderate and severe. Mild dehydration occurs when Read More