infant, child and adolescent nutrition

hot dogs, hard veggies, candy, whole grapes and peanut butter. These are all examples of

choking hazards; remember the esophagus is the size of a drinking straw up until age 5

It is overwhelming trying to decide a diet, what is a good resource for HCP for nutrition for kids is...

choose my plate

brought on by random abdominal pain, crying and nothing helps. Crying lasts longer than 3 hours or longer at least 3 times per week at the same time. Peaks at 6 weeks of age and resolves around 3-4 months of age. cause: unknown

colic

What are some physical S/S of anorexia nervosa?

-cold intolerance -abdominal discomfort -bloating -irregular menses -MALNUTRITION

What are some physical findings in bulimic patients?

-malnutrition -dehydration -electrolyte imbalances -esophageal tears and ruptures

What are the differences between ready to feed, concentrate and powdered formula?

-ready to feed: most expensive and you should not add water to it. -concentrate you add water to and it is the second most expensive. must be diluted with the appropriate amount of water to prevent electrolyte imbalances. -powdered must be diluted with the appropriate amount of water to prevent electrolyte imbalances

What are some S&S of celiac disease and how would we manage it?

1. chronic diarrhea 2. growth impairment 3. abdominal distention management: removal of gluten from diet for life. once managed intestinal damage will heal in about 6 months.

What are some clinical manifestations that we would see in failure to thrive?

1. persistant failure to eat regulalrly 2. no weight gain or weight loss in child under 6 y/o 3. erratic sleep patterns 4. irritable and difficult to sooth 5. developmentally delayed

What are some goals as nurses when dealing with a child who has failure to thrive?

1. provide adequate intake 2. promote normal growth and development 3. teach feedings routines to parents 4. respond to hunger ques

What is good to teach parents about prevention of early childhood caries?

1. smear toothpaste when teeth first start coming in up to age 3 2. after age 3 they can increase the amount but not too much to where is causes fluorosis (browning of the teeth)`

What are 5 main reasons that infants are allowed to eat complementary foods at 4-6 months and not sooner?

1. their tongue thrust is decreasing (extrusion reflex) 2. the can sit well WITH SUPPORT 3. begin to appreciate texture 4. swallow non-liquid foods 5. indicate desire for food and know when to turn away when full.

How much milk should a toddler consume in one day?

16-24 ounces

AAP says children spend an average of 7 hours on electronics daily and this should be limited to ___ per day.

2 hours

Milk production is based on supply and demand when breastfeeding. Breastmilk takes about __-__ hours to digest. And the child should be fed on demand at least ___-___ times in 24 hours.

2-3 hours and 8-12 times in 24 hours

how many teeth erupt by 12 years of age? how many teeth are there total?

22 to 26 teeth; 32 teefers

What is the AAP daily activity recommendation?

30-60 minutes daily

When does the AAP recommend the start of complementary foods into the childs diet?

4-6 months

What is a good amount of juice for toddlers?

4-6 ounces per day and should be 100% juice.

Babies on mixed formula feeding and being breastfed will be given what to prevent rickets

400 international units of vitamin D

under nutrition is considered less than the ____ percentile BMI and overnutrition is greater than _____ percentile BMI

5th and 85-95th

At what age can babies take liquid through a sippy cup?

8-9 months

Healthy ways to serve food to toddlers include which of the following? ◦Establishing a pattern of sitting at a table for meals ◦Permitting nutritious snacking in place of meals ◦Allowing some simple choices

A and C

What index is used to determine ht. and wt. proportion in children

BMI

How are complementary foods supposed to be introduced into the infants diet?

IN ADDITION TO BREASTFEEDING usually given with rice cereal mixed with breast milk or formula. Usually 1 tbsp of rice cereal stirred to a runny consistency twice per day between breastfeeding's or without breast feedings fed with a spoon.

When assessing nutritional status of all children what should we take into consideration?

age, gender, and exercise level

alternative nutritional support through IV when patients are unable to eat or absorb nutrients through the GI system.

TPN

-we want to delay cows milk until ____ -we want to delay eggs until ____ -we want to avoid fish and shellfish until

age 1 age 2 age 3

You are educating parents on the benefits of breastfeeding their child. What advantages would you include in your teaching? select all that apply. a. enhances brain development b. easily digested and absorbed c. fosters immune defense d. psychological benefits

all of the above

You are educating your pregnant patient about good sources of folic acid. These would include which of the following? a. floud b. yeast c. avacado d. green leafy veggies e. beans peas or liver f. fruits g. spinach

all of the above

-extreme weight loss -engage in long, hard workouts- excessive -peculiar ways in dealing with food -distorted body image these are all clinical manifestations of

anorexia nervosa

life threatening eating disorder that is seen around adolescence and young adulthood caused by culture, media, stress and family issues.

anorexia nervosa

When do children start losing their baby teeth?

around 6 years of age

When infants fail to eat enough food to be adequately nourished. No specific cause but some include poverty, caregiver depression, and substance abuse

avoidant/restrictive food intake disorder (failure to thrive)

Why is vitamin D important in a childs diet?

because of rickets; all infants formula or breast fed birth to 12 months get 400 internationally units per day and kids 12 months and older get 600 internationally units per day. it can also lead to a calcium deficiency.

Why is it good to have the child join you at the dinner table when you start introducing complementary foods and finger foods?

because they can start learning when it is socially acceptable to do certain things at the table and learn the consequences of their actions?

Why do babies who are breast fed like a wider variety of foods as they get older?

because they have been exposure to a wider amount of flavors from their mothers breast milk

When introducing new foods to an infants diet, we are to do it one food at a time for 4-5 days, why?

because this allows us to pin-point allergies.

Nurtion begins ___ ___ and is related to mom. After birth what the child consumes has a direct influence on their health.

before birth

we don't give babies honey before 12 months of age d/t the r/f

botulism

binge eating followed by a weight control method such as purging, laxatives, diuretics. seen mostly in whites and higher socioeconomic class, adolescent girls and young women.

bulimia nervosa

Infants grow extremely fast, when should their birth weight have tripled?

by 1 year of age

Infants have an extremely fast growing weight, birth weight is DOUBLED when?

by 4-6 months

What is our main concern about giving infants cows milk too soon?

can cause GI bleeding, anemia and interferes with the absorption of nutrition. It has a high solute load that immature kidneys have a hard time excreting.

Gluten-sensitive enteropathy (intolerance to gluten) affecting absorption initially and causes steatorrhea.

celiac dx

Why is it important to get a good amount of calcium?

d/t consumption of sweetened carbonated beverages or fruit juices. The carbonated beverage decreases calcium d/t high phosphorus count. Puts kids at risk for osteoporosis later in life since 40% of adult bone mass is included during childhood growth spurts.

How is the diagnosis for celiac disease made?

determined by fecal fat content, duodenal biopsy and removal of gluten from the diet.

form of alternative nutritional support through tube feeds such as NG of G tube. Provides calories and essential nutrients.

enteral therapy

when is it recommended that children go to the dentist

every 6 months

t/f we give children water around age 3 water to rinse their mouth when brushing teeth

false

t/f breastfeeding is a natural process between mom and baby.

false! Breastfeeding is a learned technique that is a 2 week process.

toast, cherrios, finely sliced cheese, small piece of soft cooked veggies. these are all examples of

finger foods

As you care for your patience and their families, consider how their culture and or religion plays a role in the nutritional health of the family. How will it influence your nursing care?

foods and eating customs are culturally distinct

It is not recommended that you allow a baby to sleep with a bottle. Why is this?

increases risk for otitis media and promotes dental caries

What are four common dietary deficiencies in children caused by limited foods, foods not available or good food is available but the child will just not eat it.

iron, calcium, vitamin D, folic acid.

What deficiencies are seen in vegetarian diets?

iron, fiber, calories and fat, Vit D, B12 and zinc

Why is it important for children to have folic acid?

it prevents birth defects, so it is important to have during pregnancy. All woemn ages 15-20 should have 0.4 mg per day and pregnant women should have 0.6 mg per day.

what is physiologic anorexia in toddlers?

may appear that he toddler is not eating enough but the intake over days or a week is balanced enough to meet the bodies demand.

when breast feeing, should we tell our moms and dads that they can feed their children complementary foods with their breastmilk?

no!! they shouldn't receive complementary food for at least the first 6 months.

During ages 6-12 months it is recommended that infants only drink breast milk or iron fortified formula. When is it okay to introduce cows milk into the infants diet?

not until after the first birthday

what risk factors are associated with introducing complimentary foods too soon?

obesity by the time they are 3 or obesity later in life

What is the most common nutritional issue in children?

obesity; they are more at risk for diabetes, cardiovascular disease and gallbladder disease

Finger foods are introduced when what two reflexes are developed?

palmer and pincer grasp (finger grasp) and as they begin to get teeth during the second half of the first year of life.

what is a food jag?

period of time where a child will only eat the same foods for days/weeks. Child must have 20 different exposures to foods before they decide that they don't like it.

When is a good time to start teaching kids about what foods go in the fridge, hand washing importance, etc

preschoolers

What does breastmilk stimulate the gut to do?

produce meconium (the first dark stool seen after birth)

during infancy the American academy of pediatrics recommends starting to breast feed when?

recommends breast milk through the first birthday with

What are some goals of treatment for patients with anorexia nervosa?

reinstitute normal nutrition, address psych misconceptions, reverse body image views

period of gradual growth where education regarding healthy food choices is good. Include this age group with food purchase and preparation.

school age children

When do caries likely occur?

sleeping with a bottle or juice

As the nurse, how do we manage colic?

support, good history, methods of alleviation including rhythmic music, alternate position, reduce environmental stimuli, provide tactile stimuli

what is the best indicators of a Childs health in terms of nutritional assessment?

their general appearance (physical growth)

In adolescents why is there an increased need for calories?

this is a major time for growth spurts and lots of sports (may need 2000-3000 calories per day)

we need to discourage parents to stop giving their toddlers foods with a lot of salt and additives why?

this teaches them to prefer unhealthy options.

When educating parents on toddler nutrition what should be the recommendation for when to eat?

toddlers should have 3 meals and two snacks a day and 1 of these per week should be fast food if that is necessary.

t/f adolescents have a big need for more vitamins and minerals. increased calcium, vitamins A and C, folic acid, and riboflavin

true

t/f certain ethnic groups have higher percentages of obese children such as non-hispanic blacks, mexican americans and native americans

true

t/f during infancy this is the only time in our lives where we will have such a fast metabolic rate meaning we need to pay more attention to our nutrition/hydration

true

t/f head circumference is done at every well child checkup up to age 2 and every year up to age 5

true

t/f if the child's family has a hx of allergies they should receive an allergy test.

true

t/f serving size for toddlers is 1 tbsp and they should be drinking whole milk up until age two

true

t/f sometimes failure to thrive (avoidant/restrictive food intake disorder) can be related to intellectual disabilities, AIDS, neuro, etc

true

t/f when treating anorexia weight gain should be 2-3 pounds per week in the hospital and 1/2 pound in outpatient

true

What can we do to promote weight gain in an anorexia when the child will not eat?

utilize enteral feedings or TPN

What is included in anthropometric measures and when are they taken?

weight, length and head circumference. Done at every well child appt and on admission to the hospital

Where is gluten found?

wheat, barley, rye and oats

In what instance would you add cereal to a bottle?

when prescribed by the HCP for babies with GER

How much is too much milk for a toddler

yes, 1 quart interferes with risk for obesity and desire to eat other foods.