Parents have adopted a child with the diagnosis of kwashiorkor. What is most likely to be observed when assessing this child? (Select all that apply)

Choice A reason: Kwashiorkor, a protein-energy malnutrition, causes hypoalbuminemia, reducing oncotic pressure and leading to fluid leakage into tissues, particularly the abdomen, causing edema. This is a hallmark sign, reflecting severe protein deficiency, impairing liver albumin synthesis and causing ascites, commonly observed in children with this condition. Choice B reason: Thick, oily hair is not characteristic of kwashiorkor, which causes thin, brittle hair due to protein deficiency impairing keratin synthesis. Hair may appear discolored or sparse, but not thick or oily. Edema and growth issues are more typical, making this an incorrect finding for kwashiorkor. Choice C reason: Hyperactivity is not associated with kwashiorkor, which causes lethargy due to severe protein-energy deficiency, reducing metabolic capacity and energy levels. Children appear apathetic, not hyperactive. Edema and slowed growth are hallmark signs, making hyperactivity an incorrect manifestation of this malnutrition condition. Choice D reason: Slowed growth is a hallmark of kwashiorkor, as protein deficiency impairs tissue synthesis and growth hormone function, leading to stunting. Inadequate amino acids hinder cell division and muscle development, making growth retardation a common finding in affected children, reflecting the disease’s impact on development. Choice E reason: A white streak in hair (flag sign) occurs in kwashiorkor due to intermittent protein deficiency, disrupting melanin and keratin synthesis during hair growth. This results in alternating bands of discolored hair, a classic sign of malnutrition, reflecting periods of inadequate protein intake in affected children.