NURSING 307 Quiz 4 - Pediatrics week 4 study guide -2023 -2024 Pediatrics Week 4: GI Dysfunction, Endocrine Dysfunction, and Nutrition Book14, 25, 30; ATI Chapters 22, 23, 33, 34 Portion Control Key for All Ages **Class notes: Amount of serving in kids increases by age. Nutrition by age group Infant: Toddler: Preschool: ì Fluids 160ml/kg/day ì At one month requires 100-115 kcal/kg/day ì Fats to absorb Vitamins A,D,E,K ì DHA and ARA help to develop spinal cord, visual acuity, cognitive and behavioral functions ì 400 IU/day of vitamin D is recommended for breastfeeding babies. ì Breast milk formula birth to 4-6 months ì 4-6 months incorporate rice cereal 2-3 T daily fortified rice cereal ì 6-8 months add fruits and vegetables 2-3 T three times daily avoid carrots, beets, squash, beans, and spinach before 6mn. ì 8-10 months soft finger foods three times daily ì 10-12 months most soft table foods three times daily ì Physiologic anorexia ì Quality over quantity ì 16-24 oz milk ì No more risk for iron deficiency anemia ì Limited juice consumption -dental caries ì Sliced meats, cheese, tofu, fruits, vegetables, yogurt, PB with bread -healthy snacks. ì Similar to toddler; eating as social event ì Involve in prep ì Food jags-only eats few food items. ì Three meals, two to three snacks as routine norm ì Juice 8-12 oz daily ì 5-a-day program with fruits/vegetable servings -routine diet. ì Decreased snacks “structure food plan”, leaner and taller. ì Fast food 1x week, brush teeth. ì Protein: chicken, beans, peanut butter on spread. School -Age: ì Growth spurt 10-12 years -prefers food eaten at home. ì Increased nutritional needs If Infant Is Breastfed How long does the baby nurse at each breast? What is the usual schedule for breastfeeding? Overview Questions What was the infant’s birth weight? At what age did the birth weight double and triple? Was the infant premature? Does the infant have any feeding problems such as difficulty sucking and swallowing, spitting up, fatigue, or fussiness? ì Teach to choose nutritious foods : pictures, sample food, handouts, etc. Adolescent: o Need >2000 calories daily, some may require 3000 calories daily -puberty/ growing. o Need to instill healthy diet habits o Incorporate calcium, Vitamins A and C, fiber ▪ Lacking in fast food and unhealthy food choices that are high in fats and sodium ▪ Increased calories r/t sports ** Class notes Fat is important for infants for spinal cord, vision, vitamin adek, and cognitive development. Start with breastmilk or formula. Introduce food one at time for 3-5 days for allergies. 8-9 months can have soft finger foods. 10 -12 months sit with family at table. School age: lots of nutrition teach about healthy diet and healthy foods bec ause adolescents won’t listen. Adolescent: same calories as adult. Fast food lacks incorporate components in vitamins and fiber they will have deficiency. High concentration of sodium and fat from fast food watch bp. Nutritional Assessment Physical/Behavioral Measurement: ì Use of growth charts ì BMI (accuracy based on steady growth, culture, and other variations) • Do not fixate on this because it’s not fully accurate • Negative sign of obesity in adolescent • Low carb-decreased energy • Low iron: lethargy, slow g/d, pallor. Dietary Intake: ì See tables 14-4 to 14-6 ì 24 hours recall of intake assesses adequacy of diet ì Dietary questionnaires and Food diaries (1-7 days) help to track intake and visual necessary modifications • Seeing what their overall habits are in a journal • Sudden GI upset - rule out lactose intolerance and gluten intolerance (celiac) • A: night vision, dry skin • C: skin problem, bleeding, joint tender • D: rib deformity • B: weak, decreased DTR • P: edema TABLE 14–4 Dietary Screening History for Infants What types of food or beverage does the child especially like? What foods or beverages does the child dislike What is the child’s typical eating schedule? Meals and snacks? Does the child eat with the family or at separate times? Where does the child eat each meal? Who prepares the food for the family? What methods of cooking are used? Baking? Frying? Broiling? Grilling? What ethnic foods are commonly eaten? Does the family eat in a restaurant frequently? What type? What type of food does the child usually order? Is the child on a special diet? Does the child need to be fed, feed himself or herself, need assistance eating, or need any adaptive devices for eating? Does the baby also take any milk or formula? Amount and fre- quency? What type? If Infant Is Formula -Fed What formula is used? Is it iron fortified? How is it prepared? Do you hold or prop the bottle for feedings? How much formula is taken at each feeding? How many bottles are taken each day? Does the baby take a bottle to bed for naps or nighttime? What is in the bottle? If Infant Is Fed Other Foods At what age did the baby start eating other foods? Cereal Fruit/juices Vegetables Finger foods Meats Other protein sources Do you use commercial baby food or make your own? Does the baby eat any table foods? How often does the baby take solid foods? How is the baby’s appetite? Do you have any concerns about the baby’s feeding habits? Does the baby take a vitamin supplement? Fluoride? Have there been any allergic reactions to foods? Which ones? Does the baby spit up frequently? Have there been any rashes? What types of stools does the baby have? Frequency? Consistency? TABLE 14–5 Dietary Screening History for Children