Chapter 5: Growth And Nutrition Flashcards
A&p
Food nourishes the body by supplying nutrients and calories to function in three ways:
-Provide energy for necessary activities
-Provide for building and maintaining body tissue
-Regulate body processes
The nutrients necessary to the body are classified as:
-Macronutrients: carbohydrate, protein, fat
-Micronutrients: vitamins, minerals, electrolytes
-Water
Nutrition and Growth Assessment
Nutrition assessment
-Recent growth, weight loss, or weight gain
-Chronic illnesses affecting nutritional status or intake
-Medication and supplement use
-Assessment of nutrient intake
Growth assessment
-Standing height (use stadiometer over age 2)
-Weight
-Calculation of BMI (over the age of 2)
-Waist circumference
-Waist-height ratio
-Waist-to-hip circumference ratio
Infants, Children, and Adolescents
Fetus
Head growth predominates
Infant
-Trunk growth predominates
-Weight gain rapid; decelerates after age 1
Child
-Legs are fastest growing
-Weight gained at steady rate
Adolescent
-Males develop broad shoulders and musculature.
-Females amass subcutaneous fat.
Preg pt
Progressive weight gain is expected.
Weight gain is slow in first trimester, rapid in second trimester, and slows in third trimester.
Maternal nutrition has significant impact on developing fetus.
Older adult pt
Stature declines in older adult, beginning at 50 years of age.
Body fat increases and skeletal muscle declines.
Liver, lungs, and kidneys reduce in size and weight.
HPI
Weight loss and weight gain
Can be from several causes, including medications
Changes in body proportions
Changes in fat distribution
Increased metabolic requirements
Congenital and chronic illnesses
External losses
PMH
Chronic illnesses
Previous weight gain or weight loss efforts
Previously diagnosed eating disorder
Hyperglycemia and hypoglycemia
FMH
Obesity, dyslipidemia
Constitutionally short or tall stature
Genetic or metabolic disorder: diabetes
Eating disorder: anorexia, bulimia
Alcoholism
PMH/SMH
Nutrition
Vitamins, minerals, supplements
Usual weight and height
Alcohol and drug use
Food insecurity
Functional assessment
Typical mealtime situations
Tube feedings, parenteral nutrition
Dentition
hx of special pop
Infants and children
Nutrition, unexplained changes in size, screen time, chronic illness, congenital anomalies
Adolescents
Sexual maturation, stature, nutrition, eating disorders, chronic illness, medications
Older adults
Nutrition, chronic illness, medication interactions and effects
Pregnant patients
Prepregnancy and intrapregnancy weight and BMI, eating disorders, menstrual history, pica
Determination of Diet Adequacy
24-hour recall diet
Food diary
Nutrient analysis
Choosemyplate.gov
Vegetarian and vegan diets
Ethnic food guide pyramids
Examination and Findings
Prepare appropriate equipment.
Weight and standing height
-Weight variations occur during the day.
-Measure height to nearest 0.5 inch.
Body mass index
-Undernutrition, appropriate weight for height, overweight, obesity
Waist circumference and waist-height ratio
-Indicators of visceral fat or abdominal obesity
Waist-to-hip circumference ratio
-Fat distribution by body type
Recumbent length
-Length of infant between birth and 24 months
Weight
-Growth and weight charts
Head circumference
-Measure at every health visit until 2 to 3 years
-Place the measuring tape around the largest circumference of the infant’s head, across the occiput and the forehead
Chest circumference
-Use when problem suspected
-Measurement of infant chest circumference with the measuring tape at the level of the nipple line
Gestational age
-Newborn’s maturity
-Size for gestational age
Growth Abnormalities
Acromegaly
-Excessive growth and distorted proportions
-Pituitary tumor
-Note the large head, forward projection of jaw, protrusion of frontal bone, and the large hands
Cushing syndrome
-Due to prolonged and high exposure to glucocorticoids
Turner syndrome
-Partial or complete absence of second X-chromosome
Hydrocephalus
-Excess CSF in the brain
-Paralysis of the upward gaze is seen in an infant with hydrocephalus resulting from aqueductal stenosis. It appears more apparent on the right. This phenomenon is often termed the sunsetting sign
Failure to thrive (FTT)
-3rd to 5th percentile
-Crossing downward over two percentile lines on growth curve
Prader-Willi Syndrome
-Initial FTT followed by insatiable hunger
Growth hormone deficiency
-Not enough growth hormone to support growth
Precocious puberty
-Secondary sex characteristics before 6 to 7 (girls), 9 (boys)
Nutrition Abnormalities
Obesity
-Excessive proportion of body fat
-Majority of adult obesity is from childhood obesity.
-Childhood obesity has become a major public health problem in the United States.
Anorexia nervosa
-Eating disorder of low body weight and distorted body image
Bulimia nervosa
-Eating disorder characterized by overeating and purging
The majority of adult obesity begins:
In adolescence
In childhood
After the skeletal growth is completed
Once sexual maturation is complete
During menopause
ANS: A
Rationale: Seventy percent of adult obesity begins in adolescence, before skeletal growth or sexual maturation is complete.
