Decoding Protein Malnutrition: Unraveling Kwashiorkor and Marasmus solution

Decoding Protein Malnutrition: Unraveling Kwashiorkor and Marasmus

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Decoding Protein Malnutrition: Unraveling Kwashiorkor and Marasmus

The case study I was presented was “An 83-year-old resident of a skilled nursing facility presents to the emergency

department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has a

history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with

protein malnutrition”.

 

When looking into protein malnutrition, protein energy-malnutrition is the most commonly seen terminology, or PEM,

that is the result of starvation (with or without catabolic stress). PEM is considered a disease and is the result of

chronic inadequate protein or energy intake not meeting the body’s needed intake of nutrients. In some cases, the loss of fat is reduced due to a slowed energy use accomplished by decreasing the metabolism and instead using the body’s

storage of lean protein. Typically, the majority of the protein is released from muscle tissues and the kidneys, blood,

immune cells, GI tract and liver are spared for the most part. In cases where the ration of energy and protein are not

obsolete, the body can adapt to the environment by decreasing the energy and protein needed to sustain homeostasis. PEM results in “a lowered metabolic rate and reduced muscle mass (including reduced cardiac and respiratory muscle

mass); its clinical consequences include muscle weakness and functional disability, reduced cardiac and respiratory

capacity, mild hypothermia and a reduced body protein reserve” (Hoffer, 2001). In PEM, the extracellular fluid also shifts

and can cause generalized edema.

 

In consideration of protein malnutrition, there are two conditions that come up in various articles, Kwashiorkor and

marasmus. “Kwashiorkor is predominantly a protein deficiency, while marasmus is a deficiency of all macro-nutrients — protein, carbohydrates and fats. People with marasmus are deprived of calories in general, either because they’re

eating too little or expending too many, or both. People with kwashiorkor may not be deprived of calories in general but

are deprived of protein-rich foods” (C.C. Medical, n.d.). In this case study, though the primary diagnoses is protein

malnutrition, marasmus may be more fitting and in align with the physiologic problems this patient is facing. “For older

adults, adverse health outcomes associated with malnutrition can often be more complex and dis-proportionally worse

than outcomes associated with overweight or obesity. Malnutrition in older adults can lead to weight loss. Functional recovery from this weight loss is unlikely to occur due to the loss of skeletal muscle mass, even with full nutritional

support” (Dent et. al, 2023).  “Marasmus is equally distributed between the genders, however, as a result of cultural

differences in some parts of the world women may be at an increased risk of marasmus” (NCBI, 2023).

• Respectfully agree or disagree with your colleague’s assessment and
• Explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not. Support each of your replies with at least 0ne citation and reference.

Decoding Protein Malnutrition: Unraveling Kwashiorkor and Marasmus

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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