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2030 FB PAEDIATRICS > Growth/Nutrition/Challenges > Flashcards

Growth/Nutrition/Challenges Flashcards

1
Q

infant age

A

1-12 mos

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2
Q

neonate

A

first 30 days

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3
Q

failure to thrive

A

severe disruption in attachment; take baby home and they lose weight; put in hospital and gains wait; potential for LT cognitive effects

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4
Q

gain birth wt back by

A

2 weeks

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5
Q

double birth wt by

A

4-6 mos

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6
Q

triple birth wt by

A

1 year

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7
Q

growth in length for first year

A

10 inches

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8
Q

first 3 mos wt gain per day

A

wt gain 150 gm (30 gm/day) (minimum) to 210 gm (ideal)

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9
Q

premie bbs w/o health problems catch up in growth by

A

school age (physical growth)

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10
Q

premie bbs w/o health probs catch up in development by

A

age 2

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11
Q

head circumference

A

increases 10 inches in first 6 months

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12
Q

growth in 1st year highly relatable to

A

cardiac dx, cancers, etc.

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13
Q

WHITEHALL study

A
  • studied kids from age 7
  • found 3 main predicting fators to look at at age 7
    1. ht (physical health)
    2. relationship w/primary caregiver (emotional)
    3. language skills (cognitive health)
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14
Q

infant (birth-2) kcal/kg/day req’t:

A

100-200

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15
Q

infant protein (g/kg/day)

A

2.2

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16
Q

infant fat (% dietary intake)

A

50%

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17
Q

versus adult req’ts:

A 
kcal/kg/day = 30-35
protein = 0.9
fat = 20-35%
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18
Q

primary nutrition source

A

for healthy, full-term babies

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19
Q

Primary nutrition source: breast

A

best for 6mo-2 yrs

  • biologically right nutrient for child
  • easier on GI
  • bonding
  • cheaper
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20
Q

primary nutrition source: formula

A

if not breastfed: iron-fortified cow’s milk formula to 9-12 months
iron-fortified follow up formulas preferrable to milk from 9-12 months
soy-based formulas in very rare circumstances (high allergen in children)
specialty formulas: for pathology (made by pharmacists)

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21
Q

(whole) cow’s milk delayed until

A

adequate solid food intake with vit C & iron introduced

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22
Q

delay solid food introduction until

A

6 months of age

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23
Q

take about ___ mL/kg

A

150

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24
Q

boil water

A

at least 2 mins for infants under 6 months

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25
Q

proper preparation of formula is

A

essential

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26
Q

supp: vit D

A

ALL breastfed babies from birth

  • northern locale; darker skin: increased
  • Tri Vi Sol drops in mouth every day
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27
Q

supp: iron

A

FULL TERM INFANTS: receive passive transfer in 3rd trimester; no supplementation – carries them over until solid food introduction

PREMIES: need supp from 6 weeks of age (Fer in Sol, once daily drop in mouth; SEs = darker stools, constipation, can temporarily stain teeth)

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28
Q

pros of pacifiers

A

soothing
decreased anxiety
decreased SIDS risk (recommendations that infants should be offered paci by 1 mo of age)
children like transitional objects (blankets, pacis, animals)

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29
Q

cons

A

ear infections
inc. risk for open bite (buck teeth)
sometimes not hygienic

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30
Q

Fluoride (<3ppm) supp 0-6 months

A

NONE

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31
Q

no child should get Fl before 6 mos because

A

they can get FLUOROSIS (white spots on teeth)

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32
Q

fluoride 6mo-3 years

A

0.25 mg/day

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33
Q

fluoride 3-6 years

A

0.5 mg/day

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34
Q

> 6 years fluoride

A

1 mg/day

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35
Q

fluoride benefits

A

protects teeth form cavities
most locations have FL in the water but if not, after 6 mo discuss w parents the pros/cons
- Tri Vi Fluor (drops) or tasty pink pills “pediadent”

36
Q

solid introduction @ 6 months why?

A
  • extrusion reflec - dont have mm control to eat properly before this time
  • lack neuromuscular control
  • high solute load for developing kidneys
  • alters immune protection from breast milk
  • nutritional benefit of breastmilk/formula is superior
  • taste & texture preferences develop by 6-9 mo
  • need vit C and iron in diet by 6 mo
37
Q

solid intro: 6 mo

A

pablum: (iron fortified)
1. rice pablum
2. barley pablum
3. oatmeal

38
Q

pablum rationale

A

prevention of iron deficiency anemia

39
Q

solid intro: 7 mo =

A

veggies; rationale = vitamins

40
Q

solid intro: 8 mo =

A

fruit; rationale = best source of vit A/C

41
Q

solid intro: 9 mo =

A

meat; rationale = proteins, iron, B vits

* RDs recommend protein can be introduced earlier, like 7 months ish

42
Q

solid intro: 10 mo =

A

egg yolk (iron)

43
Q

no egg white prior to

A

1 year (allergy risk)

44
Q

all eggs

A

well coooked (salmonella risk)

45
Q

limit fruit juice to

A

6 oz/day (linked to short stature, obesity, “stunting”, tooth development)

46
Q

introduce 1 food at a time; wait

A

5-7 days (allergy assessment)

47
Q

literature states earlier you introduce foods and more variety,

A

child ends up with less allergies

48
Q

no low fat milk before

A

age 2 (need 50% fat - fat required for brain growth)

49
Q

no hard, sticky, round foods

A

choking risk

50
Q

never use ____ bottle

A

propper (choking risk, not getting bonding)

51
Q

no bottles in bed

A

“baby bottle mouth” “nursing bottle syndrome”; breaks the teeth down right up to the adult teeth which come out as little brown stumps

52
Q

3 foods responsible for 90% of allergies in kids:

A

peanuts, milk, egg

53
Q

no honey/corn syrup

A

botulism risk

54
Q

progress strained to pureed to junior foods

A

follows infant capabilities

55
Q

read food labels/make own baby food

A

fewer ingredients desired (peas, water)

56
Q

a child is less likely to get allergy w these factors:

A

not first born
live in rural area (in day care - developing good immune system)
did not have antibiotics in first year of life
no genetic hx
female

57
Q

Common infant health challenges:

A
58
Q

Safe sleep environment & Reducing SIDS risk:

A

baby on back
give soother
no extras in crib
do not have them next to an outside window
same ROOM as parents (turns head toward them) but NOT same bed for first 6 months
correct environmental temperature
no smoking in house or woodstove

59
Q

atopic signs/risk factors

A 
skin very dry
rabbit nose
family hx of eczema/allergies
allergic shiners (darkness under eyes)
allergic salute (perm crease in nose from wiping runny nose)
60
Q

diaper dermatitis (rash)

A

-wash well: soap & water
-reduce urine/stool
dry well: skin folds, hair dryer
various creams: most zinc based
“diaper less” leave bum to air w/o diaper if possible
change detergent/disposable brand
washable diapers/try different diapers

61
Q

diaper rash: signs of candida infection

A

little white spots

62
Q

medication-induced diaper rash

A

STOP everything

63
Q

cradle cap description

A

large, oily scalp scales

fear of anterior fontanelle (it is OK to touch)

64
Q

cradle cap tx

A

rub in vaseline or oil

use fine tooth comb to pick out scales

65
Q

Eczema “atopic dermatitis” description

A

chronically itchy, scaly, “rough” skin
“dry” skin, red
often on cheeks, skin folds
family hx of asthma, allergies

66
Q

eczema tx

A 
clothe in natural fibres
keep fingernails short
milk may be dietary culprit
limit baths
after 5-10 mins in bath: add oil 
after bath: pat dry, use pure cream such as Galaxal base & steroid cream if needed (when an area actually develops eczema)
antihistamines
watch for other atopic signs
mittens during sleep if young
67
Q

best thing for eczema

A

keep skin well lotioned with cream

68
Q

babies with very dry skin means

A

atopically prone child - at risk for athma and allergies

69
Q

asthma presents in children with

A

generally NO wheeze; mostly nocturnal coughing, constant colds

70
Q

regurgitation/spitting up

A

return of small amount of food post feeding
relaxed cardiac sphincter
usually resolves by 2-3 months
sit upright post-feeds; no bouncing, frequent burping, smaller feeds
differentiate from GI dxs with similar presenting characteristics
refer: if persistent, projectile vomiting

71
Q

colic def’n

A

uncontrollable crying in an otherwise healthy baby

72
Q

colic: clinical presentation

A

baby is younger than 5 months old and cries for more than three hours in a row on three or more days a week for at least three weeks

73
Q

causes of colic:

A
  • stomach problems (cows milk, lactose)
  • reflux
  • spasms in growing GI system
  • gas
  • hormones causing a fussy mood
  • oversensitivity/overstimulation to light/noise etc
  • moody baby
  • still developing nervous system
74
Q

iron-deficiency anemia ‘milk fed babies’; high risk infants:

A

premie infants
infants not recieving dietary iron by age 9 mo
most common age: 9-24 mo

75
Q

iron deficiency anemia tx

A

iron drops, may need blood transfusions

dietary education; milk has no iron

76
Q

dentition & teething

A

start in prenatal life
two sets: 20 baby or deciduous
32 adult teeth

77
Q

natal teeth

A

1/2000 newborns
most mabdibular central incisors
risks & tx

78
Q

infancy teeth:

A

sequence set; timing varies

influencing factors

79
Q

teething S&S

A 
drooling
reddened cheeks
gums inflammed and reddened
irritability
chew on everything
night wakening
diarrhea & diaper rash
80
Q

teething nursing care

A 
teething rings
frozen facecloths
acetaminophem
OTC teething aids; use caution
later tooth eruption: more pain
cleaning: soft cloth
toothpaste: monitor fluoride
soothers & thumbsucking
81
Q

prematurity

A

< 37 weeks gestation

82
Q

classifications of prematurity:

A

LBW, VLBW, ELBW

83
Q

LBW

A

Low birth weight <2500g

84
Q

VLBW

A

very low birth weight <1500g

85
Q

ELBW

A

extremely low birth weight <1000g

86
Q

risks for prematurity:

A 
poverty
poor nutrition
lack of prenatal care
substance abuse
multiple gestation
age of mother
uterine/placenta abnormality
87
Q

nursing care for premies

A 
monitor growth
monitor development
promote normalization
promote attachment
infection control

2030 FB PAEDIATRICS (7 decks)

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