Koreksi

Gizi baik tapi tidak sesuai Alternatif Assasement

status gizi pada anak: LLA, grafik CP, grafik sindrom down, Arm span, tinggi duduk , knee height Jangan sebut merk obat Tata laksana nutrisi tidak dibahas Plot berat dan tinggi badan dalam grafik Keterangan gambar Penulisan daftar pustaka sesuai vancouver

Checklist points
Medical history
1. 2. 3. 4. 5. 6. 7.

Usual diet before current episode of ilness Breast feeding history Food and fluids intake Duration and frequency of vomiting, diarrhoea Time when urine was last passed Contact with people with measles, tubercilosis Any death of siblings

8. Birth weight 9. Milestones reached 10. immunization

Physical examination

Weight and length or height Oedema Enlargement or tenderness of liver, jaundice Abdominal distension, bowel sounds Severe pallor Sign of circullatory collapse Temperature Thirst Eyes: corneal lesions Ears, mouth, throat: evidence of infection Skin: evidence of infection Respiratory rate and type of respiration: sign of pneumonia or heart failure Appearace of faeces

Laboratory test
Blood glucose
Examination of blood smear by microscopy Haemoglobin Examination and culture of urine specimen Examination of faeces by microscopy Chest x ray Skin test for tuberculosis

Test that are of little value

Serum protein
HIV Electrolytes

Activity

Initial treatment Day 1-2 Day 3-7

Rehabilitation Week 2-6

Follow up Week 7-26

Treat or prevent: Hypothermia Hypoglycemia Dehydration Correct electrolyte imbalance Treat infection Correct micronutrient deficiencies Begin feeding Increase feeding to catch up growth Stimulate emotional and sensorial development Prepare for discharged

------------------- ------------------- --------------------> --------------------------------------------------------------------------- ------------------------------------- Without iron with iron ---------------------------------------XXX------------------------------- ------------------------------------- -------------------------------------------------------- ----------------------------------------------------------------------------------------------- -----------------------------

Initial treatment
Treat and prevent hypoglycemia and hypothermia
Treat and prevent dehydration and restore electrolyte

imbalance Treat incipient or developed septic shock To start to feed To treat infection Treat and identified another problems

Hipoglikemia
Larutan sukrosa atau glukosa 10% 50 ml per oral
IV Berikan makan

Antibiotika
Infeksi tidak nyata: kotrimoksasol ( TMP 4 mg/KG BB)
Infeksi nyata: ampisillin

Nutrisi
Energi 80-100 Kkal
Cairan 130 ml/ Kg F 75 F 100 Vitamin A Asam folat Prreparat besi

Composition F 75 and F 100

Amount per 100 ml F-75 Energy Protein Percentage of energy from: protein Fat Osmolality 75 Kkal 0.9 g 5% 32% 333mOsm F 100 100 2.9 g 12% 53% 419 mOsm

Criteria for rehabilitation

Eating well
Mental status has improved, responds to stimuli Normal temperature No vomiting or diarrhoea No oedema Gaining weight > 5g/kg BW per day for 3 concecutive

days

Criteria for discharge

Child 1. Weight for height has reached -1 SD NCHS/WHO gizi kurang 2. Eating adequate 3. All infections treated 4. All vitamin and mineral deficiencies have been treated

Mother or carer: 1. Able and willing to look after the child 2. Knows how to repare appropriate foods and to feed the children 3. Knows how to play with children 4. Knows how to treat diarrhoea, and time to seek medical assistance 5. Health worker: able to follow up

Terima kasih