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Life Cycle Nutrition > Child and Preadolescent Interventions > Flashcards

Child and Preadolescent Interventions Flashcards

1
Q

Children with special health care needs have a wide range of nutritional requirements such as:

  • ______ needs if small muscle size
  • ______ is needed if protein losses or skin breakdown
  • ______ is needed if frequent vomiting or diarrhea
  • ______ for chronic constipation
  • ______ due to DNI
A

Lower energy
High protein
Increased fluid
High fiber
Increase or decrease in micronutrients

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2
Q

higher protein needs for recovery from ____ or ______

_____ requires 150% of DRI fro protein
_____ require decreased protein

A

burns or wounds

cystic fibrosis
PKU

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3
Q

___________ are a good starting place for assessing growth
* Adjustments may need to be made for children with some conditions that affect the rate of growth
* _____ is not an appropriate tool for some conditions (i.e. cerebral palsy, paralysis)

A

CDC 2000 growth charts

BMI

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4
Q

what are some warning signs for growth problems

A

plateau in weight

pattern of gain and then loss

failure to regain weight lost during an illness

unexplained or unintentional weight loss

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5
Q

Intake may not be the only factor affecting growth for kids with chronic conditions
Other factors that affect growth assessment:
* Age of condition onset - ____ onset is more
likely to affect growth
* Secondary conditions may interfere with accurate measurements
- Example: ______ in children with cerebral palsy
* Activity level may be decreased

A

earlier

scoliosis

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6
Q

Down syndrome results in short stature and low muscle tone and low weight due to _____________ (rather than nutritional intake)

Spina bifida may impact muscles only in the ____

Identified low fat stores means you need to _____ food intake

A

neuromuscular changes
lower body
increase

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7
Q

Growth charts are available for some special conditions
* Some special growth charts are only based on the ______ form of the condition
* Many chronic conditions have such a wide range of severity that growth charts _____ be developed

A

most severe
cannot

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8
Q

conditions that do not have growth charts

A

juvenile rheumatoid arthritis
cystic fibrosis
Rett syndrome
spina bifida
seizures
diabetes

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9
Q

Children with special health needs often ____ from same general dietary recommendations as other children
* Assess intake to determine if energy & nutrient needs are being met
* Undernutrition may result in decreased effectiveness of _____ and _____ interventions

A

benefit

educational
medical

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10
Q

_____ feeding is preferred method of feeding
* May require ______ in addition to or to partially replace meals or snacks

_____ feeding may be required for:
* Some cancers
* Severe cerebral palsy
* Cystic fibrosis
* Pediatric AIDS

A

oral
supplements

Gastrostomy

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11
Q

Cystic fibrosis with pancreatic insufficiency=> requires__________ supplementation in ______ form

A

fat-soluble vitamin
water-soluble

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12
Q

Galactosemia=> requires _____ supplementation

A

calcium

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13
Q

Chewing problems=> need _____ supplements

A

liquid

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14
Q

Children on ketogenic diets=> avoid supplements with _______

A

added CHO

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15
Q

Children with PKU=> avoid supplements with _____

A

aspartame

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16
Q

DRI for water is appropriate for most children:
* Age 4-8: ____ L/d
* Age 9-13: ____ L/d females & ____ L/d males

A

1.7

2.11
2.4

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17
Q

conditions that increase fluid needs include:

A

Constipation from neuromuscular disorders
Crohn’s disease
Medication side effects
Uncontrollable drooling (from cerebral palsy)

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18
Q

____% of children with developmental delays have feeding difficulties

A

70 %

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19
Q

Examples of feeding problems include:
* ______ skills are lower than the child’s chronological age, requiring assistance & supervision
* Meals take an _____ amount of time
* The condition requires ______ in the timing of meals & snacks

A

Self-feeding
excessive
adjustment

20
Q

Dysfunction of the ______ glands that results in production of abnormally ____ secretions that obstruct glands & ducts
* ____system disorder
* Interferes with _____ function=> Dyspnea, frequent respiratory infections, & permanent lung damage
* Pancreatic insufficiency=> ________ due to lack of pancreatic enzymes

A

exocrine
thick

multi

lung
malabsorption

21
Q

nutritional issues for cystic fibrosis include

  • _______ nutritional needs due to work of breathing, frequent infections, and malabsorption
  • ______ oral intake
  • Nutrient _______
  • ______ rate of growth
  • ______ risk for malnutrition
A

Increased
decreased
deficiencies
slower
high

22
Q

Energy needs vary widely: _____ times the DRI for age
* Frequent meals & snacks
* If pancreatic insufficiency=> ________ taken with all meals & snacks to aid in digestion
* MVI with minerals and _________ supplements
* _________ feeding at night may be needed to boost energy intake

A

1.1-2.0
pancreatic enzymes
fat-soluble vitamin (in water-soluble form)
PEG/gastrostomy

23
Q

Disorder in insulin regulation and glucose metabolism

A

diabetes mellitus

24
Q

problem and intervention for Type 1 diabetes mellitus

A

virtually no insulin production

CHO counting
Education on meal planning

25
Q

problem and intervention for Type 2 diabetes mellitus

A

high blood sugar only

Education on meal planning
weight management

26
Q

Sudden, excessive, and disordered electrical disturbances in the brain

A

Epilepsy and seizures (same disorder)

27
Q

Results of a seizure range from ______ to _______
* When seizures are well-controlled by medications, ______usually continues at a typical rate

A

mild blinking
severe jerking

growth

28
Q

treatment of seizures and epilepsy

A

Eating during postictal state is not recommended due to the risk of choking

  • Medications—may impact appetite and nutritional status
  • Ketogenic diet—used as a last resort in children with intractable seizures when all other drug therapies fail
29
Q

Broad range of disorders resulting from brain damage early in life with impaired muscle activity & coordination

A

cerebral palsy (CP)

30
Q

_____________ is the form of CP that presents with the most nutritional problems

A

Spastic tetraplegia/quadriplegia

31
Q

cerebral palsy side effects

A

primary
- muscle stiffness

secondary
- contractures
- scoliosis
- GERD
- constipation

32
Q

nutrition concerns with cerebral palsy

A
  • Difficulty with feeding & eating
  • Slow weight gain & growth
  • Changes in body composition which cause:
    • Fatigue at meal times, spilling food, long meal times, requiring assistance to eat
    • Dysphagia due to difficulty controlling
      muscles of neck & back for sitting up and muscles of jaw & tongue
33
Q

energy needs of cerebral palsy

A

difficult to determine

  • Children with small or weak muscles have
    lower energy needs
  • Children with athetosis (uncontrolled
    movements of the large muscle groups) have increased energy expenditure
34
Q

nutrition interventions for cerebral palsy

A
  • Adjusting menus and timing of meals & snacks
    at home or school to meet nutritional needs and address fatigue
  • Adaptive feeding devices
  • Dysphagia assessment and interventions
35
Q

PKU is an inborn error of metabolism

  • Absence or deficiency of ___________
    – the enzyme needed to ______________
  • It accumulates in the ____ and is toxic to _____
    – without treatment it causes _____
A

phenylalanine hydroxylase
metabolize phenylalanine to tyrosine

blood
brain tissue
severe intelectual disability

36
Q

treatment of PKU

A

Lifelong restriction of phenylalanine
* 80-90% of protein needs is met by a phenylalanine-free formula

Dietary treatment includes complete avoidance of:
- meat, fish, eggs, dairy products, nuts, legumes, & soybeans

37
Q

Most common neurobehavioral condition in children is ______

what percent ?

A

ADHD
11%

38
Q

medication for ADHD that can affect Nutrition ?
how so?

A

Ritalin and Adderall

  • may decrease appetite
39
Q

nutrition intervention for ADHD

A

Time meals considering medication action peaks
* e.g. Providing a large, healthy evening snack when medication effects are lower

*No proven evidence of nutrition as a cause or as a treatment but families still often choose to use herbal medicines & nutrition supplements

40
Q

Treatment of pediatric HIV includes ______, which may lead to ______.

A

antiretroviral therapy
anorexia (loss of appetite)

41
Q

pediatric HIV nutrition interventions?

A

–Educating family on DNI and feeding schedules
–Education to prevent food-borne illness
–Assessing for financial difficulties and referral to services (i.e. food bank)

If inadequate intake, use of
–Oral nutrition supplements
–Gastrostomy tube feeding

42
Q

childhood celiac disease is a _____ condition which is _____ in prevalence. It is also ______ in children, maybe bc it ______.

A

chronic
increasing

under diagnosed
presents differently in children

43
Q

celiac disease may interfere with _____ and ____.

most effective treatment is ________.

A

learning and growth

avoiding gluten for life

44
Q

department of education public school regulations includes
* _____ accommodations
* Requires that school provide a _______ to accommodate for special health care needs

A

504
written plan

45
Q

A law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children

  • Nutritional services may be written into a child’s _____________
A

Individuals with Disabilities Education Act (IDEA)

Individualized Education Program (IEP)

Life Cycle Nutrition (21 decks)

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