Chapter 10 - Exam 2

Question 1

Toddlers

Answer 1

1-3 years old

characterized by rapid increase in gross/fine motor skills

Question 2

Preschool-age children

Answer 2

3-5 years old
11.8 mil in US
characterized by increasing autonomy, broader social circumstances, increasing language skills, and expanding self control

Question 3

Importance of nutrition status

Answer 3

during toddler and preschool years, adequate nutrition is required to achieve full growth and development
undernutrition impairs cognition and ability to explore environment

Question 4

Toddler and Preschool health

Answer 4

Healthy People 2020 - objectives for nation for improvements in health status by 2020
(some ex; increase fruits and veggies in diet, increase in consumption of whole grains and calcium, and to reduce calories from fats, sugars, and sodium)

Question 5

Normal growth and development

Answer 5

from birth to 1 year, average infant triples birth weight
toddlers gain 2.7 kg (6.1 lb) and 12 cm (4.7 in) per year
preschoolers gain 2 kg (4.4 lb) and 7 cm (2.8 in) per year

Question 6

Monitoring Children’s Growth

Answer 6

use calibrated scales and height board
toddlers - under ager 2 weighed without clothing or diaper, determine recumbent length
preschoolers - over age 2 weighed with light clothing, measure stature with no shoes

Question 7

2000 CDC Growth Charts

Answer 7

gender specific
age specific (birth to 36 months, and 2 to 20 years)
monitor for weight-for-age, length/stature-for-age, head circumference for age, BMI for age

Question 8

WHO Growth Charts

Answer 8

growth standards for children from birth to 5 years

international growth standards regardless of ethnicity or socioeconomic status

Question 9

Toddler: Walking Development

Answer 9

progress by month;
15 - crawl up stairs
18 - run stiffly
24 - walk up stairs one foot at a time
30 - alternate feet going up stairs
36 - ride a tricycle
(fascinated with skills, with no sense of dangers, leading cause of death in toddlers due to unintentional injury)

Question 10

Toddler: Cognitive Development

Answer 10

toddlers "orbit" around parents
vocab expands;
10-15 words at 18 months
100 at 2 years
3-word sentences at 3 years
(increased determination to express own will, temper tantrums common)

Question 11

Toddler: Development of Feeding Skills

Answer 11

12-14 months - completely weaned
gross/fine motor development improved;
12 months - refined pincer
18-24 months - able to use tongue to clean lips/rotary chewing

Question 12

Toddler: Feeding behaviors

Answer 12

rituals in feeding common
may have strong preferences and dislikes
imitate parents/siblings
involve child in meal selection and prep

Question 13

Meal Prep activities for young children

Answer 13

2 years - tear lettuce, rinse veggies/fruit, snap green beans
3 years - mash potatoes, squeeze citrus fruits, stir pancake mix
4 years - peel eggs/fruit (bananas or oranges), crack eggs, help with sandwiches and tossed salads
5 years - measure liquids, cut soft fruits with dull knife, use egg beater

Question 14

Toddler: Food Intake

Answer 14

toddler-sized portions ~ 1 tbsp per year of age

nutrient dense snacks

Question 15

Preschool-Age: Cognitive Development

Answer 15

cooperative and organized group play
vocab expands to > 2,000 words (begin using complete sentences)
control is central issue (childs challenge is to separate)

Question 16

Temperament

Answer 16

Behavior style of a child (3 main temperaments);

• 40% “easy” - adapts to regular schedules and accepts new foods
• 10% “difficult” - slow to adapt and may be negative to new foods
• 15% “slow-to-warm-up” - slow adaptability, negative to new foods but can learn to accept
• remaining styles are “intermediate low” to “intermediate high” with a mixture of behaviors

Question 17

Preschool-Age: Feeding Behaviors

Answer 17

can use fork, spoon, and cup
spills occur less frequently
appetite related to growth, increases prior to “spurts” of growth

Question 18

Preschool-Age: Energy Intake

Answer 18

children adjust caloric intake to match caloric needs, avoid encouraging to “clean plate”
healthful eating habits must be learned

Question 19

Preschool-Age: Feeding Relationship

Answer 19

• parent or caretaker; “what” children are offered to eat, environment in which food is served including “where” and “when”
• Child; “how much” to eat

Question 20

Energy Needs: Calories

Answer 20

estimated energy requirement (EER) for 1-3 year olds - (89 x weight (kg) - 100) + 20
*(ex:) 12 kg child = (89 x 12 - 100) + 20 = 988 kcal/d

Question 21

Energy Needs: Protein

Answer 21

1-3 years - 1.1 g/kg/d or 13g/d

4-8 years - 0.5 g/kg/d or 19 g/d

Question 22

Energy Needs: Vit/Min

Answer 22

1-3 years - Iron 7 mg/d, Zinc 3 mg/d, Ca 700 mg/d
4-8 years - Iron 10 mg/d, Zinc 5 mg/d, Ca 1,000 mg/d
varied diet provides all vit/min needed, AAP recommends no supplements unless;
from deprived families, poor appetites/diets, consume only a few types of food
1 in 2 three year olds take supplements when not rec. to

Question 23

Actual Nutrient Intake

Answer 23

meet or exceed intake for energy, protein, fat, and most vit/min requirements
sodium intake at 2,600 mg/d when only 1,000-1,200 mg/d recommended
iron, zinc, Ca, and Vit D/E tend to be lower
25% children 4-8 years old consume fast food

Question 24

Physical Activity Recommendations

Answer 24

60 mins of PA everyday

Question 25

Common Nutrition Problems

Answer 25

Iron-deficiency 
dental caries
constipation
elevated blood lead
food safety
overweight/obesity

Question 26

Iron Deficiency

Answer 26

-toddlers (1-2 yo) - 15.9% are iron-deficient (with little physiological problems)
-preschoolers (3-5 yo) - 5.3% iron deficient
may result in delays in cognitive development
reduction on number of RBC’s (insufficient intake/absorption of iron

Question 27

Iron Deficiency: Prevention

Answer 27

limit milk consumption on 1-5 yo to 24 oz/d

increase meat consumption, iron supplements, repeat screening

Question 28

Dental Caries

Answer 28

1 in 3 children ages 3-5
causes;
streptococcus mutans (bedtime bottle with juice or milk, stick carb foods)
prevention with fluoride

Question 29

Constipation

Answer 29

hard, dry stools associated with painful bowel movements
prevention - adequate fiber
1-3 yo - 19 g/d total fiber
4-8 yo - 25 g/d total fiber

Question 30

Elevated Blood Lead Levels

Answer 30

~ 0.9% children 1-5 yo
low levels of lead linked to lower IQ and behavioral problems
high levels may decrease growth
reduce lead poisoning by eliminating sources of lead

Question 31

Food Safety

Answer 31

key foodborne pathogens;
-campylobactr: handling raw/uncooked poultry, infected feces, unpasteurized milk or unchlorinated water
-salmonella: raw/undercooked eggs
-E coli: undercooked meat, unpasteurized apple cider
-listeria monocytogens: undercooked meats, unpasteurized milk
Prevention - clean hands/surfaces, separate foods, cook properly, chill promptly

Question 32

Overweight/Obesity

Answer 32

BMI for over 2 yo;
- ≥95% = obese
- 85-94% = overweight
- < 5% = underweight
12.1% of children 2-5 yo are obese (no significant gender/ethnicity differences)
Prevention is best treatment

Question 33

Treatment of Overweight/Obesity

Answer 33

4 stage approach

1: Prevention Plus
2: structured weight management (SWM)
3: comprehensive multidisciplinary intervention (CMI)
4: tertiary care intervention (TCI) - not appropriate for toddlers/preschool age children