Nutrition Chapter 13: Nutrition for Infants, Children, and Adolescents

The nurse is seeing a parent with an 11-year-old boy for a well child visit. The parent expresses concern that the child has not grown as tall as the parent expected by this age. How should the nurse respond?

"A growth spurt should begin in about one year." -The slow growth of childhood abruptly and dramatically increases with pubescence until the rate is nearly as rapid as that of early infancy. Adolescence is a period of physical, emotional, social, and sexual maturation. Approximately 15% to 20% of adult height and 50% of adult weight are gained during adolescence

A nurse is providing nutrition education for a group of parents. Which of the following should she recommend for formula feeding?

"Be consistent about formula temperature." -Formula may be given at room temperature, slightly warmed, or directly from the refrigerator; however, always give formula at approximately the same temperature each time. Position the infant so that the head is higher than the rest of the body. Avoid jiggling the bottle and making extra movements that could distract the infant from feeding. A steady drop from the nipple should be observed from an upside-down bottle.

A father is concerned because his baby spits up a small amount of formula after many feedings. Which of the following should the nurse recommend?

"Burp the infant more often." -Spitting up a small amount of formula during or after a feeding is normal. The infant should be fed more slowly and burped more frequently to help alleviate spitting up. Burping can be accomplished by gently rubbing or patting the infant's back as he or she is held on the shoulder, lies on his or her stomach over the caregiver's lab, or sits in an upright position.

A parent is asking the school health nurse how much her son is expected to grow before he reaches puberty. Which is the correct response from the nurse?

"He will grow 2 to 3 inches per year." -Physical growth rate during childhood is slow and steady. Annually, children gain an average of 7 pounds and 2.5 inches in height. Body fat increases in preparation for the adolescent growth spurt.

A nurse is providing nutrition education for a group of caregivers. Which of the following should the nurse recommend for formula feeding?

"Stop feeding when babies turn away from bottles, as this is a sign that they are finished."

A client tells the nurse that she does not eat chocolate because she is prone to acne. How should the nurse respond?

"That might help, since diet can aggravate acne" -Scientific evidence does not demonstrate that diet causes acne, but diet may aggravate it. The implicated dietary factors are a high glycemic diet and dairy products.

What teaching points will the nurse recommend in a newborn class to help alleviate spit up from formula fed infants? Select all that apply.

- Feed the infant more slowly. - Burp the infant more frequently.

Breast milk contains enzymes to help with the digestion of which nutrients? Select all that apply.

- Lipids - Carbohydrates

When screening an adolescent for obesity, which risk factors will the nurse recognize? Select all that apply.

- Parental obesity - Inadequate sleep - Low family income

Which recommendation(s) will the nurse give to parents to best guide their toddlers to make healthy food choices and thereby decrease the risk of overweight, obesity and disordered eating? Select all that apply.

- Parents determine what food is served. - Parents determine when food is served. - Children will learn to eat the food their parents eat.

The nurse is assessing a mother and her 10-month-old infant at the office for a regular check up, and the mother has inquired about which foods she can serve to her infant now. Which response will the nurse give? Select all that apply.

- Teething biscuits - Finely chopped fruit - Finely chopped vegetables - Yogurt

Girls generally experience increases in growth between

10 and 11 years of age and peak at 12 years. Because peak weight occurs before peak height, many girls and parents become concerned about what appears to be excess weight.

boys usually begin the growth spurt at about

12 years of age and peak at 14 years.

Brianna was 6 pounds at birth. Her weight will be approximately ____ pounds by 4 to 6 months and approximately ____ pounds by 12 months.

12, 18 -Birth weight doubles by 4 to 6 months of age and triples by the first birthday.

The MyPlate empty calorie allowance for 7- to 9-year-old girls is

120,

A client has a BMI of 16 when she is two years old. She can maintain this BMI until she is ___ years old before she would be classified as underweight.

14 -A BMI of 16 is in the healthy weight range for girls from age 2 to 14 years old.

A five-year-old male is above the 85th percentile with a BMI of approximately:

17 -A five-year-old male is above the 85th percentile with a BMI of approximately 17. A BMI of 18 would be in the 95th percentile. A BMI of 19 or 28 would be in the 97th percentile.

term formulas have

20 calories per ounce.

The school health nurse is seeing a 12 year old female who asks when she is likely to stop growing taller. Which answer should the nurse give the child?

21 years old.

Stature growth ceases at a median age of approximately

21 years.

enriched formula has

22 calories per ounce,

Preterm formula has

24 calories per ounce,

When referring to body mass index (BMI), what number is correlated with the start of the obese category?

30 -Weight status in children and adolescents is defined by BMI percentiles specific for age and sex. During late adolescence, adult cutoffs for overweight are a BMI greater than 25. For obesity, it is a BMI greater than 30.

A 13-year-old pregnant teen had BMI of 20 before pregnancy. How many pounds should she gain during pregnancy

30-35 -Teenagers within the healthy BMI range should gain 25 to 35 pounds or more during pregnancy if they are very young. A BMI of 20 for a 12-year-old is in the healthy weight range.

The nurse determines that an adolescent client's BMI is 32, placing the client's BMI-for-age at the 97th percentile. The nurse understands that this client's risk for adult diabetes is approximately how much greater than that of an adolescent with a healthy weight?

300% -A high BMI (or BMI-for-age) during adolescence increases adult diabetes risk by almost threefold, or 300%.

The MyPlate empty calorie allowance for 15 year old boys is

360

The American Academy of Pediatrics recommends that breastfeed and partially breastfed infants be given supplemental iron (1 mg/kg/day of a liquid preparation) starting at

4 months.

Whole grapes, watermelon with seeds, celery, and carrots are choking hazards for children until the age of

4 years.

The nurse knows what proportion of children in the United States are overweight or obese?

41% -Currently, 41% of children and adolescents are overweight or obese, and the prevalence is higher among Hispanic and non-Hispanic Black children and adolescents than non-Hispanic Asians and Whites.

A seven-year-old child is in the normal weight range for the age. What percentile range does this correspond to on the standard growth chart?

5th to 85th percentile

Fluoride should not be given during the first

6 months of life.

The Recommended Dietary Allowance (RDA) for calcium is highest in which age group?

9 to 18 years - For boys and girls from age 9 to 18 years, the Recommended Dietary Allowance (RDA) for calcium is 1300 mg—higher than at any other time in the life cycle. The RDA drops to 1000 mg/ day for young adults aged 19 to 21.

What is the definition of milk anemia?

A child drinks too much milk which displaces the intake of iron-rich foods.

Which of the following is a CORRECT explanation about the relationship between breastfeeding and obesity?

Breastfed infants have a lower risk of obesity in some populations. -Formula-fed infants generally grow more quickly than breastfed infants during infancy. Formula-fed infants have a lower frequency and a longer interval between feedings than is typical for breastfed infants. Some of the potential health benefits for the infant include reduced risk of diarrhea and respiratory tract infection; possible protective effect against inflammatory bowel disease, leukemias, and certain types of type 1 diabetes, lowered risk of obesity in some populations, lower risk of atopic illness, and close mother-infant bonding.

The nurse is seeing an adolescent client who frequently skips meals. Which of the following information can the nurse offer the client about this eating behavior?

Children who skip breakfast may also exercise infrequently. -Adolescent females are more likely to skip breakfast than males of similar age, and African American adolescents are more likely to skip breakfast than White adolescents. Overall, breakfast skipping tends to increase with age and seems to be associated with other lifestyle factors that may be detrimental to health such as dieting and infrequent exercise.

The nurse knows which of the following is true about preterm infant formula?

Contains more calories and some nutrients than term formulas -Preterm formulas are designed to promote "catch-up growth." They are higher than routine formulas in calories, protein, and certain minerals. Premature infant discharge formulas are less calorically dense than preterm formulas but higher in calories than term formulas. They are used to supplement breastfed preterm infants

The nurse recognizes which of the following statements about breastfeeding is CORRECT?

Exclusive breastfeeding is related to decreased rate of weight gain in infancy.

The nurse is discussing lifestyle modification strategies with a 15-year-old female who is concerned about developing obesity. Which of the following should the nurse recommend?

Increase the nutrient density of meals. - The goals of obesity treatment are to improve long-term physical and psychosocial health by establishing permanent healthy lifestyle behaviors and changes to the environment where the child or adolescent lives. Obesity prevention strategies for children and adolescents with a healthy BMI include permanent lifestyle modifications aimed at the following: Consuming a nutrient-dense healthy eating pattern, decreasing sedentary behaviors, increasing physical activity, obtaining adequate sleep.

The nurse is providing teaching about infant formula to a prenatal group. Which of the following statements about term infant formulas by the nurse is CORRECT?

Infant formulas all have similar amounts of nutrients.

Which recommendation will the nurse give about introducing solid foods in infants?

Introduce single-ingredient foods one at a time so that allergic reactions, such as rashes, vomiting, or diarrhea, can be identified. -Generally, single-ingredient foods are introduced one at a time so that allergic reactions, such as rashes, vomiting, or diarrhea, can be identified. After 3 days, not 30 days, of apparent tolerance, another new solid food may be introduced. To limit the likelihood that infants will become picky eaters, a variety of colors, flavors, and textures should be offered. Establishing regular meal times and snack times instead of continuous grazing will help prevent overweight and obesity

Which of the following is a nutrient that is deficient in some older American infants?

Iron -Iron is found to be deficient in some older American infants. Around 6 months of age, breast milk or formulas are not adequate as the sole source of nutrition and nutrient-dense, developmentally appropriate complementary foods become necessary. Complementary foods, also known as solids, are added to the infant's diet at about 6 months of age and when the infant is developmentally ready. Infant iron stores are usually adequate for about the first 6 months of life so the first solids offered should be iron-rich foods, such as meats, seafood, and iron-fortified infant cereals. Iron-fortified cereal or pureed foods are usually recommended as first foods; there is no evidence to support any particular order or rate for introducing other solids. Protein, preformed vitamin A, and sodium are not typically deficient in this demographic.

A new father is asking for ways to help his child develop healthy eating habits. Which of the following is a recommendation for creating a positive eating environment?

Never force a child to eat. -Never force a child to eat; if a healthy child is hungry, he or she will eat. Offer a variety of foods, not just the ones the parents like. Fat and cholesterol should not be limited in the diets of very young children. Do not use food to reward, punish, bribe, or convey love.

Which of the following about general growth during adolescence is CORRECT?

Peak growth of females occurs before that of males.

The school health nurse is seeing a 10-year-old girl and her mother about weight concerns. Which factor will the nurse explain to the mother may be lower in overweight or obese girls than in thin girls?

Quality of life -Youth who are obese are at risk for becoming obese adults; the higher the degree of excess weight, the more likely obesity will persist into adulthood (Singh et al., 2008). Chronic conditions related to obesity previously seen only in adults, such as type 2 diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cardiovascular disease, are now affecting an increasing number of adolescents and even children (Hagan et al., 2017). Children and adolescents with obesity are also more likely to experience psychological concerns (e.g., anxiety, depression) and social concerns (bullying, stigmatization), which affect quality of life. Substance abuse, inactivity, and social isolation are not factors that are lower among overweight or obese girls.

A baby is 9 months old and can hold a cup and spoon feed himself. His development is _____ for his age.

ahead

The nurse is admitting a 1-year-old infant to the pediatric unit with dehydration and flu-like symptoms. The infant's mother is concerned about her ability to continue to breastfeed her baby. The nurse recognizes this will affect the child's nutritional status. Which of the following nursing diagnosis would be MOST appropriate in this situation?

Risk of altered nutrition: interrupted feeding

The nurse is seeing a family who wants to make changes to their eating pattern to decrease obesity in all of the family members. The family eats out frequently. The nurse recognizes that a significant amount of food the family eats is high in which of the following?

Saturated fat

The Healthy Eating index-2015 found that one of the reasons overall diet quality for all childhood age and ethnic groups is excessive intake of which of the following?

Sodium -Across the 5 to 8-year-old, 9 to 13-year-old, and 14 to 18-year-old age groupings, consumption of total vegetables, all vegetable subgroups, fruit, dairy, whole grains, and seafood was below recommended levels of intake. Consumption of refined grains, added sugar, saturated fat, and sodium was above recommended levels of intake.

An infant's parents are vegans and would like to raise their children on vegan diets. Which infant formula should the nurse recommend?

Soy

Which of the following statements is MOST likely to be true?

The prevalence of overweight and obesity has been increasing in the United States for 4 decades.

Which of the following would be true of the total calorie needs of a four-year-old girl and a six-year-old girl?

The six-year-old needs more total calories. -Total calorie needs steadily increase during childhood, although calorie needs per kilogram of body weight progressively fall.

A client is a new mother. Which of the following is correct advice about breastfeeding?

To help maintain milk production, avoid formula -Early substitution of formula or introduction of solid foods may decrease the chance of maintaining lactation.

A new parent is asking for ways to help their child develop healthy eating habits. Which of the following is a recommendation for creating a positive eating environment?

Toys, books, and/or screens should be removed from the table. - Healthy child-feeding practices are critical for helping children develop healthy eating habits later in life. Toys, books, and/or screens should not be used during mealtime to avoid distracted eating. Children should not be pressured or cajoled into eating more. Avoid empty calorie foods. Hot dogs, burgers, pizza, cookies, cakes, and candy are only occasional treats. Sweet drinks, such as flavored milk, plant-based milks (except for soymilk), artificially sweetened drinks, sugar-sweetened beverages, and caffeinated drinks, should be avoided. Portions offered should be small. Allow the child to ask for more. Give children the opportunity to improve self-feeding skills, even though it may be messy. Toddlers and preschoolers are often ready to leave the table after 15 to 20 minutes -- food should be removed from the table at that time. Eating with the family is associated with better diet quality and lower rates of overweight/obesity and less disordered eating.

Breast milk contains

amylase to promote carbohydrate digestion when pancreatic amylase levels are low and contains lipases to promote fat digestion. High cholesterol content may help infants develop enzyme systems capable of handling cholesterol later in life.

A baby is 7 months old and can sit without being supported, puts food between her jaws, and eats mashed food from a spoon. Her development is _____ for her age.

appropriate -Developmental skills for age 5 to 9 months include beginning to sit alone unsupported, positioning foods between the jaws for chewing, beginning to eat mashed foods, and eating from a spoon.

The nurse is seeing a teenaged client who is pregnant and has a BMI of 20. The nurse should recommend the client gain how much weight?

approximately 35 lbs -Adolescents within the healthy BMI range should gain approximately 35 pounds to reduce the risk of delivering an LBW infant.

During a one-day diet analysis, a three-year-old child ate 1 cup of fruit, 1.5 cups of vegetables, 4 ounces of grains, 4 ounces of proteins, and 2.5 cups of milk. According to the Healthy Eating for Preschoolers Daily Food Plan, his intake was:

at the recommended daily range for all food groups. -The Daily Food Plan lists 1 to 1.5 cups of fruit, 1.5 cups of vegetables, 4 to 5 ounces of grains, 3 to 4 ounces of proteins, and 2.5 cups of dairy for 3-year-old preschoolers.

The nurse is helping a mother plan snacks for an 18-month-old child. Which of the following snacks should the nurse recommend the mother include in the child's eating pattern?

banana bread

Supplementation with 400 IU of Vitamin D begins soon after

birth and continues until the child routinely receives adequate amounts from other sources; for breastfed or partially breastfed infants, that may not be until after they begin consuming whole milk at age 12 months or later.

Signs that an infant is finished include

biting the nipple, puckering the face, and turning away from the bottle. Caregivers should recognize that babies cry for reasons other than hunger and should not be fed every time they cry, nor should infants be forced to finish their bottles. To avoid nursing bottle caries, infants and children should not be put to bed with a bottle of formula, milk, juice, or other sweetened liquid.

Which of the following is one of the five major sources of calories among 14- to 18-year-olds but not one of the six foods that make up half of empty calories among children and adolescents?

chicken -The five major sources of calories among 14- to 18-year-olds are soda, pizza, grain desserts, yeast breads, and chicken. Half of their empty calories come from six foods: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.

Post-puberty adolescents have a growth rate similar to that of which age group?

early infancy. -The slow growth of childhood abruptly and dramatically increases with pubescence until the rate is as rapid as that of early infancy.

Important concerns during childhood include

excessive intakes of calories, sodium, and fat, especially saturated fat. - Nutrients most likely to be consumed in inadequate amounts are calcium, fiber, vitamin E, magnesium, and potassium.

After a child is born, when is growth faster than at any other time in a lifespan?

first 12 months -Excluding fetal growth, growth in the first year of life is more rapid than at any other time in the life cycle.

The nurse is seeing a client with her infant for a well baby visit. The client breastfeeds exclusively. The nurse correctly informs the client that her child should not receive what supplement until 6 months of age?

fluoride

Which of the following is the BEST choice of snack for a child who is 10 months old?

french fries -French fries are a preferred food and one that is easy to chew for children under the age of one. This choice of snack does not pose a choking risk. The snacks in the other answer options pose a risk for choking in children under the age of one.

Children who are within the 5th to 85th percentile on the standard growth chart are considered to be of

healthy, normal weight.

Developmental skills for 10 to 12 months include beginning to

hold a cup, put spoon in mouth, and self spoon feed with help.

Decreased levels of which of the following minerals can increase the risk of small-for-gestational age births in pregnant adolescents?

iron -Compared with adult women, pregnant adolescents may have poor intake and status of certain micronutrients, such as folate, iron, and vitamin D, which increases the risk of small-for-gestational age births in pregnant adolescents. Folate and vitamin D are vitamins, and iron is a mineral.

Infants who consume formula exclusively likely receive adequate ........

iron and vitamin D without additional supplementation.

Milk anemia is an

iron deficiency anemia related to excessive milk intake, which displaces the intake of iron-rich foods from the diet. It does not refer to inadequate milk consumption, adquate nutrients in breast milk, or milk that is low in iron.

The nurse is seeing a mom and her two-year-old child who needs to consume more fruits and vegetables. Which of the following foods should be recommended?

leafy greens

A two-year-old child had a six-inch tortilla with one-half cup of cooked rice and one-quarter cup of cooked beans but consumed no other grains or protein that day. According to the Healthy Eating for Preschoolers Daily Food Plan, she consumed:

lower than recommended amounts of grains and protein. -The Daily Food Plan lists 3 ounces of grains and 2 ounces of protein foods for a 2-year-old. One 6-inch tortilla is 1 ounce, and one-half cup of cooked rice is 1 ounce of grains. One-quarter cup of cooked beans is 1 ounce of protein.

Compared to formula-fed infants, breastfed infants:

may be programmed to different dietary habits later. -It is postulated that early exposure to differences in taste may program infants to different food selection and dietary habits. Formula-fed infants consume more protein per kilogram than breastfed infants. Breastfeeding during early infancy is associated with greater appetite regulation later in childhood. Breastfed infants are less likely to be given complementary foods at less than 4 months of age.

Which of the following is among the top five major sources of calories in 14- to 18-year-olds?

pizza pretzels -Empty calorie intake far exceeds empty calorie allowance in all age-sex groups. The five major sources of calories among 14- to 18-year olds are soda, pizza, grain desserts, yeast breads, and chicken.

Which of the following formulas has the HIGHEST concentration of calories?

preterm

To help infants older than 6 months of age obtain adequate iron, which of the following types of meat would be best?

red meat -Chicken and turkey provide less heme iron than red meats. Hot dogs, sausages, and cold cuts are lower in iron and zinc than plain meats.

The nurse recognizes a parent requires nutritional education if her children consumes which of the following in excessive amounts?

sodium

A family is concerned about isoflavones and wants to consume foods with minimal or no isoflavones. Which of the following infant formulas should they avoid?

soy

Isoflavones are found in

soy formulas.

Intramuscular vitamin K is recommended after

the first feeding and within the first 6 hours of life.

When their MyPlate empty calorie allowance is compared, a 15-year-old boy can consume ____ empty calories as an eight-year-old girl.

three times as many

A study found that normal-weight teenage girls were ____ as likely to attend college as obese female adolescents.

twice -Obese girls were half as likely to attend college as normal-weight girls.