Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012
description
Transcript of Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012
![Page 1: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/1.jpg)
1
Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran
Universitas BrawijayaMalang
27 Pebruari 2012
MNT for Life Cycle Condition
![Page 2: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/2.jpg)
2
Sudahkan Anda Membaca ???
![Page 3: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/3.jpg)
3
Mengapa?
![Page 4: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/4.jpg)
4
Nutrition Care Process (ADA,2003)
Relationship between
Patients/client/group and
Dietetics Professional
Nutrition assessment • obtain/collect timely and appropriate data• analyze/interpret with evidence-based standards• document
Nutrition diagnosis • identify & label problem
• determine cause/ contributing risk factors
• cluster signs & symptoms/ defining
characteristics• document
Nutrition interventions • plan nutrition
Intervention- Formulate goals & determine
a plan of action• implement nutrition
intervention- Care is delivered & actions are carried out
• document
Nutriton monitoring & Evaluation • monitor progress• measure outcome indicators• Evaluate outcomes• document
Practice Settings
Social Systems
Econ
omic
s
Hea
lth
Care
Sy
stem
s
Code
of Et
hics Skills &
competencies
Dietetics Knowledge
Communication Collaboration
Crit
ical
Thi
nkin
g
Evid
ence
-bas
ed
Prac
tice
![Page 5: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/5.jpg)
5
![Page 6: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/6.jpg)
6
Contents
Definition1
Causes2
Assessment & Diagnosis3
Treatment4
![Page 7: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/7.jpg)
7
Definition
Malnutrition is defined as “a state when the body does not have enough of the required nutrients (under-nutrition) or has excess of the required nutrients (over-nutrition)
National Guideline for Integrated Management of Acute Malnutrition, 2009
tablefor2.org.hk
![Page 8: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/8.jpg)
8
Chronic malnutrition
Stunted
Acute malnutrition
• MAM• SAM
Malnutrition
• Marasmus• Kwasiorkor• Marasmus
kwasiorkor
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 9: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/9.jpg)
9
![Page 10: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/10.jpg)
10
Assessment & Diagnosis
A B C D
Antropometri
Biokimia
Fisik/ Klinis
Dietary
![Page 11: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/11.jpg)
11National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 12: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/12.jpg)
12
Fisik/klinis
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 13: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/13.jpg)
13
Critria To Determain In-Patient or Out-Patient
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 14: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/14.jpg)
14
Treatment
Traditionally the treatment of severe acute malnutrition has been in-patient, healthfacility based. However, recent research in emergency settings has revealed that severe uncomplicated acute malnutrition can be treated at home with weekly visits to a health facility for monitoring and re-placement of specialized food
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 15: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/15.jpg)
15
Balita Gizi Buruk tanpa KomplikasiPenanganannya PGBM
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
PMT : 500 kkal – 10 mgg
Penyuluhan konseling
Pemantauan BB, TB/PB
Stimulasi tumbuh kembang
BB tidak naik 50 g/ mgg dalam 3 mg
Gizi BurukTanpa Komplikasi
![Page 16: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/16.jpg)
16
Penatalaksanaan Balita Gizi Buruk dengan Komplikasi
syamilhafiy.blogspot.com
fianzoner.blogspot.com
![Page 17: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/17.jpg)
17
Treatment
WHO, 2003
![Page 18: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/18.jpg)
18
Rehabilitation
Transition
Stabilization
rapid weight-gain phase (catchup growth), and covers preparation for discharge
covers a gradual increase in diet leading to some weight gain while preventing complications of over-feedingcovers nutrition and medical stabilization, treatment of medical complications
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 19: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/19.jpg)
19
Stabilisasi
Fase awal mengatasi kegawatdaruratanMilk diet only F 75Makanan : jumlah sedikit dan rendah osmolaritasPemberian : oral atau NGT, hindari penggunaan parenteralLanjutkan pemberian ASI
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 20: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/20.jpg)
20
Zat Gizi pada Fase Stabilisasi
MACRONUTRIENTEnergi :80 – 100 kkal/kgBB/hari
Protein :1 – 1,5 g/kgBB/hari
Cairan :130 ml/kgBB/hari100 ml/kgBB/hari jika edema berat
MICRONUTRIENTVitamin A :- 6 – 12 mo : 100.000
IU (kapsul biru)- 12 mo & older :
200.000 IU (2 kapsul biru)
Asam Folat : 5 mg jika anemia
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 21: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/21.jpg)
21
Frekuensi Pemberian F 75
Pada anak dengan nafsu makan baik dan tanpa edema, jadwal di atas dapat dipercepat menjadi 2-3 hari.
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 22: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/22.jpg)
22
Teknik Pemberian Makanan
![Page 23: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/23.jpg)
23
10 Jam berikutnya
Letargis
Syok
Diare/ muntah
Diatasi pada 2 jam pertama
Stabilisasi
F 75
Glukosa 10% iv bolus, 5 ml/kgBB
O2 1 – 2 L sadarRL & D 10%, 15 ml/kgBB dlm
1 jam
Resomal 5 ml/kgBB (25ml) NGT/oral
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
Bila diare lagi Resomal 50 – 100 ml (< 2 thn), 100 – 200 ml (≥ 2thn)
![Page 24: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/24.jpg)
24
Fase Stabilisasi
Monitoring : Jumlah makanan yang diberikan dan
dihabiskan Muntah Frekuensi defekasi dan konsistensi
fese Berat badan
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 25: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/25.jpg)
25
Fase Transisi
Transisi
Stabilisasi
Rehabilitasi
Appetite has improvedreduced from severe +++ to moderate++Treatment for any medical complication has commencedIV fluids and NG feeding completed
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 26: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/26.jpg)
26
Fase Transisi
Energi : 100 – 150 kkal/kgBB/hari
Protein : 2 – 3 gram/hari Cairan 150 ml/kgBB/hari
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 27: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/27.jpg)
27
Fase Transisi
Awal fase transisi
Hari ke 3
Hari ke 4
F 100 diberikan tiap 4 jam dengan volume menggunakan volume F 75 yang terakhir
F 100 dengan dosis sesuai dengan BB4 jam berikutnya dosis dinaikkan 10 ml secara bertahap
F 100 diberikan setiap 4 jam. Dengan tidak melampaui batas max
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 28: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/28.jpg)
28
Fase Rehabilitasi
Transisi
Stabilisasi
Rehabilitasi
• Good appetite• Loss of oedema• Medical complications have resolved
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 29: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/29.jpg)
29
Fase Rehabilitasi
Energi : 150 – 220 kkal/ kgBB/hari Protein : 4 – 6 g/ kgBB/ hari Cairan 150 – 200 ml/kgBB/hari
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 30: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/30.jpg)
30
Fase Rehabilitasi
F 100 + makanan biasa (usia > 24 bulan)
F 100 + makanan bayi (mulai bubur saring, bubur beras, bubur susu, nasi tim)
BB < 7 BB ≥ 7 Kriteria Pulang
Selera makan baikGejala klinis baikPenambahan BB ≥50 g/kgBB/ minggu selama 2 minggu berturut turut
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 31: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/31.jpg)
31
Fase Rehabilitasi
Monitoring Nafas dan nadi : jika ada tanda gagal
jantung kurangi volume makanan menjadi 100 ml/kgBB/hari selama 24 jam ditingkatkan 115 ml/kgBB/hari selama 24 jam 130 ml/kg BB/hari selama 48 jam
BB : kurang (< 5g/kgBB/hari), sedang(5 – 10 g/kgBB/hari), baik (10 g/kg BB/hari)
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 32: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/32.jpg)
32
Fase Tindak Lanjut
Fase pemulihan gizi balita di rumah PGBMDiberikan makanan tumbuh kejarKontrol secara berkala
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 33: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/33.jpg)
33
PMT : 500 kkal – 10 mgg
Penyuluhan konseling
Pemantauan BB, TB/PB
Stimulasi tumbuh kembang
BB tidak naik 50 g/ mgg dalam 3 mg
Fase TindakLanjut
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 34: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/34.jpg)
34
syamilhafiy.blogspot.com
fianzoner.blogspot.com
![Page 35: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/35.jpg)
35WHO, 2003
![Page 36: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/36.jpg)
36
Hypoglycaemia
Signs of Hypoglycaemia Low body temperature Lethargy or limpness Possible loss of consciousness Blood glucose : < 54 mg/dl
National Guideline for Integrated Management of Acute Malnutrition, 2009
(Buku II: Petunjuk Teknis Tata Laksana Gizi Buruk, tahun 2003)
![Page 37: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/37.jpg)
37
Hypoglycemia 1
• 50 ml sugar-water (10%
glucose)
2Berikan larutan
glukosa 10% secara intravena
(bolus) sebanyak 5 ml/ kg BB.
Selanjutnya berikan larutan
glukosa 10% sebanyak 50 ml via
oral/NGT
Tidak sadar
3Berikan cairan intravena RL :
dekstrosa 10% = 1:1 (RLG
5%)sebanyak 15 ml/kg BB untuk 1 jam pertama atau
5 tetes/menit/kgBB.
Selanjutnya berikan lar.
Glukosa 10% iv (bolus) sebanyak
5ml/ kg BB
Shock Sadar
F 75 tiap 30 menit selama 2 jamDirektotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009 dan WHO 2003
![Page 38: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/38.jpg)
38
Hypoglycemia
Preparation of sugar water (10% dilution)
Notes:Take clean drinking water (slightly warm if possible to help dilution). Add required amount of sugar and shake or stir vigorously.
National Guideline for Integrated Management of Acute Malnutrition, 2009
![Page 39: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/39.jpg)
39
Hypoglycemia
Monitoring Kadar gula darah : Jika < 54 mg/dl ulangi pemberian
larutan glukosa/ gula 10% Jika suhu rektal < 35.5 atau
kesadaran memuruk ulangi pengukuran gula darah
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 40: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/40.jpg)
Suhu rectal < 35.5ºC under-arm temperature < 35ºC Biasanya terjadi bersama-sama dgn hipoglikemia Hipotermia + hipoglikemia : merupakan tanda
dari adanya infeksi sistemik serius Cadangan energi balita gizi buruk sangat
terbatas , sehingga tidak mampu memproduksi panas utk mempertahankan
40(Buku II: Petunjuk Teknis Tata Laksana Gizi Buruk, tahun 2003)
Hypothermia
National Guideline for Integrated Management of Acute Malnutrition, 2009
Monitoring : Suhu aksilar tiap 2 jam Kadar glukosa darah
![Page 41: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/41.jpg)
41
Treatment of Hypothermia Use the “kangaroo technique” for
children with a caretaker
National Guideline for Integrated Management of Acute Malnutrition, 2009
Unicef.org
![Page 42: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/42.jpg)
42
Dehydration
ReSoMal
F 75 Resomal
F75
beri 5 ml/kgBB setiap 30 menit untuk 2 jam pertama
setelah 2 jam, berikan ReSoMal 5–10 ml/kgBB/jam berselang-seling dengan F-75 selama 10 jam
10 jam berikutnyaDirektotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 43: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/43.jpg)
43
Dehydration
Monitoring : Keadaan klinis tiap 30 menit selama 2
jam pertama, dan tiap 1 jam sampai 10 jam
Periksalah :- Frekuensi nadi- Frekuensi nafas- Jumlah produksi urin- Frekuensi BAB dan muntah
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 44: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/44.jpg)
44
Gangguan Elektrolit
Untuk mengatasi gangguan elektrolit diberikan Kalium dan Magnesium, yang sudah terkandung di dalam larutan Mineral-Mix yang ditambahkan ke dalam F-75, F-100 atau ReSoMal
Gunakan larutan ReSoMal untuk rehidrasi
Siapkan makanan tanpa menambahkan garam (NaCl).
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 45: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/45.jpg)
45
Infeksi
Hipotermia dan hipoglikemi merupakan tanda infeksi berat
Tangani dengan antibiotik
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 46: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/46.jpg)
46
Defisiensi Zat Gizi Mikro
Berikan setiap hari paling sedikit dalam 2 minggu: Multivitamin Asam folat (5 mg pada hari
1, dan selanjutnya 1 mg/hari) Seng (2 mg Zn
elemental/kgBB/hari) Tembaga (0.3 mg
Cu/kgBB/hari) Ferosulfat 3 mg/kgBB/hari
setelah berat badan naik (mulai fase rehabilitasi)
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
Vitamin A
![Page 47: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/47.jpg)
47
Penanganan Kondisi Penyerta
1• Tranfusi darah, jika
Hb< 4 g/dl dan Hb 4 – 6 g/dl + gangguan pernafasan
• Hentikan pemberian cairan via oral/NGT ketika tranfusi
2• F 75 rendah laktosa• Pada kasus tertensu
diberikan susu rendah laktosa
Lactose intoleranceAnemia
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 48: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/48.jpg)
48
Resep ReSoMal
Direktotat Jenderal Bina Kesehatan Masyarakat, Depkes RI 2009
![Page 49: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/49.jpg)
49
![Page 50: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/50.jpg)
50
![Page 51: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/51.jpg)
51
![Page 52: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/52.jpg)
52
![Page 53: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/53.jpg)
53
Tugas Baca
![Page 54: Leny Budhi Harti Jurusan Gizi Fakultas Kedokteran Universitas Brawijaya Malang 27 Pebruari 2012](https://reader035.fdocuments.net/reader035/viewer/2022062501/568165f9550346895dd92735/html5/thumbnails/54.jpg)
www.themegallery.com