Chapter 11 Lutz

Lead poisoning

•Sources of lead: old paint dust/chips (e.g., older housing) •Consequences of lead poisoning: cognitive deficits •Associated with iron-deficiency anemia

Energy nutrition during infancy

1. Adequate energy reflected in satisfactory gains in length and weight 2. No low-fat diets (Omega-3 fatty acids needed)

Stage 2 (3-6) new foods

1. Don't give up after first try 2. May take 9-10 times of introducing a food before the child will accept it.

iron nutrition during infancy

1. Iron from breast milk more absorbable: no supplementation 2. Formula that is not iron fortified: supplementation

Type 2 Diabetes risk factors

1. Overweight and obesity 2. Genetics and race

Stage 2 (3-6) food jags

1. Wanting one particular food 2. Parents educate on variety of food for nutrients

stage 2 (3-6) food jags

1. Wanting one particular food 2. Parents educate on variety of food for nutrients

Protein nutrition during infancy

1. needs highest during first 4 months 2. Excess protein affects renal solute load

Families should be encouraged to provide fortified whole milk for children until the age of 1. 18 months 2. 2 years 3. 36 months 4. 4 years

2 Correct. At age 2, fat intake should gradually be reduced to 30% to 40% of a child's intake, and transitioning to low-fat or fat-free milk is recommended.

Type 2 diabetes treatment

2. Include the family 3. Goal: maintain current weight while growth continues 4. Educate on dietary patterns (MyPlate) 5. Goal: develop and maintain a healthy lifestyle

A nurse in a clinic would identify which of the following infants as needing additional assessment of growth? 1. Baby girl A, 4 months old, birth weight 7 lb 6 oz, present weight 14 lb 14 oz 2. Baby boy B, 2 weeks old, birth weight 6 lb 10 oz, present weight 6 lb 11 oz 3. Baby boy C, 6 months old, birth weight 8 lb 8 oz, present weight 14 lb 8 oz 4. Baby girl D, 2 months old, birth weight 7 lb 2 oz, present weight 9 lb 10 oz

3 Correct. An infant should double its birth weight by age 4 to 6 months. A 6-month old with a birth weight of 8 lbs 8 oz should weigh at least 17 pounds.

Which of the following foods would be appropriate for a 6-month-old infant? 1. Cocoa-flavored wheat cereal, orange juice, and strained chicken 2. Graham crackers, strained prunes, and stewed tomatoes 3. Infant rice cereal, mashed banana, and strained squash 4. Mashed potatoes, strained beets, and chopped hard-cooked egg

3 Correct. Rice cereal can be introduced at age 4 months and strained fruits and vegetables between 5 to 7 months old.

Which of the following individuals is at greatest nutritional risk? 1. 3-month-old infant being fed commercial formula 2. 3-year-old child who drinks 3 cups of milk a day 3. 8-year-old child who eats four chocolate chip cookies and drinks two glasses of milk after school 4. 16-year-old girl who is pregnant and attempting weight loss

4. Correct. Pregnant teens require additional calories and nutrients to support both their growth and the growth of the fetus. Weight loss should never be attempted during pregnancy, especially with a teen mother.

Obesity p.201

Increases among children and adolescents

Ms. C has given a 24-hour dietary recall for her 18-month-old son. The nurse is alert to identify common causes of choking. To avoid choking accidents, which of the following foods would be considered safest for a toddler? Select All That Apply. a. Grapes b. Diced peaches c. Popcorn d. Watermelon chunks e. String cheese

Diced peaches and watermelon chunks

Encourage?

Encourage staying in touch with internal cues of hunger/satiety and being physically active

Growth slows, but body is preparing for growth spurt of puberty

May be reflected in pre-puberty weight gain (chubbiness typical but not alarming

Peer influences increase

Noting what others get for lunch/snack at school

inborn errors of metabolism

Phenylketonuria and Galactosemia. Clinical application 11-3 p.185

Vitamin K nutrition during infancy

administered shortly after birth by injection or orally

Food asphyxiation

•Toddlers and elderly persons at higher risk •Foods associated with choking (peanut butter, peanuts, popcorn, hotdogs, etc.) •To reduce risk: make sure they are sitting down while eating and chew food well

failure to thrive

•inadequate growth or inability to maintain growth (Inadequate caloric intake most common etiology) •Organic •Nonorganic

Stages

Stage 1 - 0 to 3 Stage 2 - 3 to 6 Stage 3 - 6 to 12 Stage 4 - 12 to 20

Ms. K has delivered a 3-lb 8-oz premature infant. She had planned to breastfeed. On which of the following statements should the nurse base her teaching? a. Human breast milk can be specially fortified for premature infants to increase its nutritive value. b. Because of their larger proportion of body weight as water, premature infants need supplemental water after every feeding. c. Formula feeding is advisable because room temperature feedings are better absorbed than those at body temperature. d. Breastfeeding a premature infant offers no advantage to the infant and is difficult for the mother because of the necessary supplements

a. Correct. Human milk from the infant's mother is the gold standard to nourish VLBW infants Compared with term mothers' milk, preterm milk has more protein, sodium, and host defense factors but less calcium, phosphorus, and magnesium. Human milk fortifiers add protein, carbohydrate, vitamins, and minerals to the breast milk

Mrs. T is having her 2-month-old son checked in the well-baby clinic. She tells the nurse that the baby is not sleeping through the night yet. Mrs. T's mother advised her to start the infant on cereal to "fill him up" at bedtime. Which of the following statements by the mother would indicate to the nurse the need for further teaching? a. "My baby can have solids at 6 months." b. "Most babies sleep through the night by age 3 months." c. "I will put the infant cereal into a bottle and enlarging the nipple hole." d. "I understand that early introduction of foods may increase the risk for allergies."

c. Correct. The American Academy of Pediatrics recommends exclusive breastfeeding (nothing but breast milk and vitamins, minerals, and medications) for the first 6 months of life. If solid foods are introduced too early, the infant may develop allergies because of the permeability of the intestine. Enlarging the nipple hole can contribute to choking.

birth to 4-6 months

formula types, preparation and storage

Childhood stage 1: Toddler

issues of autonomy

Birth to 4-6 months: Breastfeeding

on demand vs. scheduled

Vitamin D nutrition during infancy

supplementation recommended for breastfed infants

Intervention for obesity

•Assess for motivation/weight-associative disorders •Focus on healthy lifestyle behaviors

Intro to solid foods

•Begin between ages 4 and 6 months •Developmental readiness •Solid Foods During the First Year of Life (Table 11-7, p. 188) •Satiety cues •Self-feeding: ages 9 to 12 months •Allergies: introduce solid food gradually •Home-prepared foods, commercial foods, or both •Variety

Responsibility for own behavior increases, but adult guidance still required in?

•Encourage meal patterns •Involve this age group in preparation of meals •Physical and emotional support of adults •Guidelines for dietary patterns: My Plate •Keep kitchen stocked with healthy snack options •Adjusting to demands of college environment •Influenced by fast food

toddler problems with excess milk and juice intake

•Fill up on milk and juice; do not contain iron, and not eat enough iron containing foods such as meat, poultry, eggs, or legumes.

Toddler serving size guidelines

•Fruit or vegetable serving: 1 tbsp per year of age •Bread and cereal: one fourth of adult serving •Milk: 2 to 3 cups per day •Meat or meat alternative: offered twice a day

Childhood ages 1-12

•Growth fluctuations •National Center for Health Statistics growth charts •Dietary Reference Intakes (DRIs) (refer to front cover) •Dietary Guidelines for Americans: for children older than 2 years of age •Role of adults in nourishing children

Stage 2 (3-6) eating characteristics

•Independent eating styles •Variable hunger and appetite levels (1. Appetite fluctuates 2. Should be able to hold out for meals with snack between)

Toddler mealtimes

•Maintain consistency •Regulate portion sizes •Encourage self-feeding •Include snacks

Beverages during the 1st year of life

•Monitor fruit juice consumption. •All juices must be pasteurized. •Baby Bottle Tooth Decay

Etiology

•Multifactorial: snacking, meals away from home (larger portions, high fat), decreased activity

Healthy snack options

•Popcorn, fruit, milk •Open faced peanut butter sandwich with fruit •Apple with peanut butter •Smoothie

Iron deficiency Anemia

•Risk factors: Poverty and Lead Poisoning {{Note: Lead poisoning and iron-deficiency anemia may be diagnosed at same time (e.g., child at high risk for iron deficiency anemia who lives in low-income family living in older housing)}} •Affects ability to learn •Public health issue