Chapter 13 Flashcards
Children with special health care needs may have additional nutritional needs. List some examples:
a. High protein is needed with high protein losses
b. High protein is needed with high protein losses, such as skin breakdown
d. High fluid volume is needed with frequent losses through vomiting and diarrhea
e. High fiber may be needed for chronic-constipation management
Factors that determine energy needs in children with special health care needs include:
a. Activity level
b. Frequency of illness
c. Growth
What is the appropriate response for parents of a child with cystic fibrosis who has recurrent illnesses?
Children with CF require close monitoring to avoid malnutrition as the condition progresses. Intensive nutrition intervention may be required to meet higher energy needs.
food refusal are common with recurrent illness, so total intake may be more variable day to day than in other children of the age
Explain spinal muscular atrophy.
Condition in which muscle control declines over time as a result or nerve loss, causing death in childhood
Protein needs for children with special health care needs are _____ those for other children.
Higher than, lowr than, or the same based on the condition
List 2 conditions that INCREASE protein needs:
a. Wound healing
b. Casting after surgery to prevent skin breakdown
Children with chronic conditions may have more difficulty meeting the DRI for vitamins and minerals because of:
a. Eating or feeding problems may restrict intake of foods requiring chewing, such as meats, so that certain minerals usually contributed in meats may be low
b. Prescribed medications and their side effects can increase turnover for specific nutrients, raising the recommended amount needed
c. Food refusals are common with recurrent illness, so total intake may be more variable day to day than in other children of the same age
d. Treatment of the condition necessitates specific food and nutrient restrictions, so that vitamins and minerals usually provided in restricted foods have to be supplemented
If a child’s condition is known to change the rate of weight or height gain, which of the following signs would indicate a need for attention?
a. A plateau in weight
b. A pattern of gain and then weight loss
c. Not regaining weight lost during an illness
d. A pattern of unexplained and unintentional weight gain
Chronic conditions without specialty growth charts include the following:
a. Juvenile Rheumatoid Arthritis
b. Cystic fibrosis
c. Rett syndrome
spina bifida, seizures, diabetes type 1 and type 2
Children with _____ and __________would always be interpreted as overweight on standard growth charts because they have altered muscle size and/or short statures.
a. CP ( results in short statues, low muscle tone, low weight)
b. Down syndrome (may reduce muscle tone)
c. spina bifida (reduce muscle tone. may impact muscles only in the lower extremities)
What percentage of children with developmental delays have feeding problems?
70%
Many families experience difficulties when their child requires nutritional supplementation with a gastrostomy because:
a. eating is such an important aspect of parenting
b. requires test and surgical procedures to create a gastrostomy and monitor it over time
c. insurance coverage and financial questions of paying for complete nutritional supplements
Normal amounts of carbohydrates are NOT allowed on what type of diet?
Ketogenic diet, or those made with an artificial sweetener containing phenylalanine not recommended for children with PKU
Fat-soluble vitamin supplements are recommended for children with _____ due to poor intestinal absorption of these nutrients.
PKU
Galactosemia may impact a child’s intake of which mineral:
Calcium
The incidence of cystic fibrosis is highest among which ethnic group?
Caucasians
How do energy and protein needs for children with cystic fibrosis compare with those of healthy children?
calories & protein increase 2 to 4 fold
List some nutrition interventions that might be appropriate for all children with cystic fibrosis:
a. monitoring growth
b. assessing food and nutrient intake
c. increasing energy and protein by 2-4 times the usual recommendations to compensate for malabsorption
Which nutrient is freely used in ketogenic diets?
Fat
severely low-CHO diet with increase calories from fat
Define athetosis.
less common form of CP – uncontrolled movement which increase energy expenditure
Which type of diabetes is characterized by virtually no insulin production?
Type I
What is included in dietary treatment for diabetes?
a.timing and composition of meals and snacks
b insulin injections → for type I
c.exercise
What is often a secondary effect of cerebral palsy?
contractures, scoliosis, gastroesophageal reflux, and constipation
Why do children with cerebral palsy often have constipation?
because coordinated muscle movements are part of bowel emptying, including the muscle in and over the intestines.
The mother of a child with cerebral palsy bought vitamin and mineral supplements containing two times the recommended amounts for healthy children after hearing that her child’s growth was slowed but going well. What would you tell her?
a. no specific vitamins and minerals are known to correct CP
b. problem nutrients are likely to be those related to bone density → calcium and vitamin D or nutrients needed in higher amounts as a result of medication side effects
c. recommendations for energy needs are difficult to determine, even with an in-depth growth assessment
Nutritional consequences of spastic quadriplegia include changes in body composition—true or false.
true
Define Phenylketonuria
An inherited error in phenylalanine metabolism most commonly caused by a deficiency of phenylalanine hydroxylase, which converts the essential amino acid phenylalanine to the non essential amino acid tyrosine.
Children with phenylketonuria have to replace approximately 80% of _____ intake from foods with a mixture of _____ from which phenylalanine has been removed.
protein and amino acids
What are some foods that would be allowed on a diet for PKU?
a. Natural sources of protein such as regular crackers, potato chips, rice, potatoes
b. many fruits & vegetables are encouraged if offered without added sources of protein
c. Some,e foods that are high in fats and/or low in sugar and gen low in natural protein such as fried vegetables or candy canes are safe.
What are some foods that would be omitted from a diet for children with
phenylketonuria?
a. Meat
b. Eggs/ Dairy Products
c. Peanuts/ Soybeans
Explain 504 Accommodation and IDEA
IDEA- special education services may have specific nutrition services written into a childs IEP
504 Accommodation- Modifies regular curriculum teaching methods to fit a child’s educational needs
A psychostimulant is a medication given to children with what condition?
ADHD
It is estimated that _____ of school-age children have attention deficit hyperactivity disorder (ADHD).
5 to 8 %
Nutritional concerns in ADHD include:
a. psychostimulant medication side effects that decrease appeptite
b. growth while being medicated
c. mealtime behavior
Why is it important to take pancreatic enzymes if a child has cystic fibrosis?
Children with CF suffer from malabsorption due to the lack of pancreatic enzymes
Plan an acceptable breakfast choice for a child on a ketogenic diet.
Eggs with ham and cheese
or
Protein shake with added peanut butter and unsweetened almond milk
