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158 PEDS > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Infant Nutrition

A
  • Breastfeeding and bottle feeding are both acceptable methods
  • Breastmilk and formula provide all the infant’s nutritional daily requirements until 4 to 6 months of age

•Cognitive developmental is supported by an adequate diet in infancy

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2
Q

Infants - Solid Food readiness

A
  • Tongue extrusion reflex (necessary for sucking) needs to disappear
  • Ability to swallow solid foods
  • Sit unsupported in high chair
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3
Q

Introducing Solids to infants

A
  • Rice or oatmeal infant cereal first
  • Start with a thinner consistency
  • New food every 4 to 7 days (allergies)
  • No salt, sugar or seasonings should be added
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4
Q

Solid foods for 6 to 8 months

A
  • Soft table foods can be added
  • Cheerios
  • Avoid hard food pieces
  • Use of a cup

Solid foods do not substitute for breastmilk or formula which should still be their primary source of nutrients until 12 months

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5
Q

Infants – Foods to Avoid

Until 12 months

A
  • Honey
  • Peanuts, popcorn, hard foods, grapes and hot dogs
  • Strawberries
  • Cow’s milk
  • Peanut butter
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6
Q

Toddlers food needs

A
  • DONT reduce fat intake of a child less than 2 years of age
  • calcium daily (but limit milk intake, too much calcium not enough iron)
  • 19 grams of fiber daily
  • limit juice - offer water between meals
  • 3 meals and 2 snacks daily
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7
Q

Toddlers – Promoting self feeding

Many be hungrier during growth spurt

A
  • Use child size utensils
  • Do not force feed or utilize the “clean plate” rule
  • Keep toddler in a secure chair at a comfortable height
  • Never leave the toddler unattended at meal times
  • Promote a family meal time
  • Minimize distractions during meals ( avoid just sitting in front of tv)

Constipation can decrease appetite

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8
Q

Preschoolers

A
  • Continue the principles discussed for toddlers
  • By age 5, can understand the social context of meal time
  • More likely than toddler to try new foods
  • Will enjoy helping with food preparation and clean-up
  • Promote a family meal time
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9
Q

Obesity – Toddlers and Preschoolers

What causes it and what can be done to prevent?

A

•More prone to obesity if a parent is obese

  • Unlimited 🧃 and 🥛 consumption
  • Do use the “Clean your plate” rule
  • Offering high sugar “junk food” just so child will eat
  • Not starting healthy eating habit from birth (ranch for 🥕 or 🧀 for 🥦 will help them eat healthy)
  • Offer new choices multiple times
  • Do not use food as a reward or punishment
  • Use a structured meal time
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10
Q

School age

A

Needs vary by size, age, gender and activity level
•Appetite⬆️ but caloric needs⬇️
•Diet choices established earlier will continue
•More influenced by parents, peers and social media
•Offer a high quality PROTEIN with each meal
•Increased CALCIUM needs
•Still benefits from a family meal time

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11
Q

School Age - Obesity is caused by

A
  • Lack of exercise and time outside
  • More “screen” time
  • Unstructured meal time
  • Increased consumption of sugar laden beverages
  • Peer influence
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12
Q

Adolescents needs

And what to avoid and encourage

A

•Higher caloric needs
- May appear to be constantly hungry
•Higher calcium and protein needs

  • avoid “specialty” diets
  • Habits will continue as adult
  • Encourage physical activity daily
  • Family meal times are still very important
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13
Q

Adolescents - Obesity

What to encourage to prevent obesity?

A 
•Encourage healthy eating habits
   - less fast food 
   - fruits and vegetables 
•Include adolescent in meal planning with family
•Exercising with peers and family
  • Obesity as an adolescent is a direct link to obesity as an adult
  • Influenced by peers
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14
Q

Anemia

A
  • Iron deficiency anemia is the most common cause of anemia in childhood.
  • Often occurs when transitioning from formula to whole milk. Infant formulas are iron fortified. When formula is stopped the child is not receiving enough iron from other food sources.
  • Cow’s milk actually makes it harder for the body to absorb iron. Toddlers can develop iron deficiency anemia if they drink too much cow’s milk (more than 24 ounces a day) and do not eat enough foods that are rich in iron such as green leafy vegetables and red meat.
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15
Q

Anorexia

A

causes more complications and adolescent deaths, distorted body image; has social, psychologic, behavioral, cultural and physiologic components

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16
Q

Bulimia

A

binge eating accompanied by purging, may be cyclic, may not change physical appearance, a psychologic disorder

Bulimics have a much higher recovery rate than anorexic adolescence

17
Q

Failure to thrive (FTT)

A

 Inadequate growth resulting from an inability to obtain or use calories required for growth.
 The deceleration of growth for both weight and height.
 Diagnosis is based on growth parameters that
1) drop more than 2 percentiles from baseline,
2) are persistently below the third to fifth percentiles.

18
Q

Gastroesophageal Reflux (GER)

A

Passage of gastric contents into the esophagus
Most infants outgrow reflux by 12 months; particularly common in preemies

Sphincter is very lose- when burp may throw up a little, don’t shake after eating !

Will eventually tighten, standing and sitting up and more solid foods will help as well

19
Q

Gastroesophageal Reflux Disease (GERD)

What complications develop

A

most involve the airway and can be life threatening in infants:

 Esophagitis
 Anemia
 Recurrent pneumonia
 Asthma
 Bradycardia
 Apnea
 ALTE
20
Q

Therapeutic Management of GERD

A

 Depends on severity. No therapy is needed for infant who is thriving and has no respiratory complications.

 Keeping head elevated for at least 30 minutes after feedings.
 Prone position should NOT be used due to increased risk of sudden infant death syndrome (SIDS)
 Small frequent feedings, space between feedings should still be permitted to allow formula in stomach
time to digest.
 Burping infant frequently (after every 1 to 2 ounces) during feeding, and after
feeding.
 Using pre-thickened formulas such as Enfamil AR
 For older children, decrease foods that exacerbate acid reflux (caffeine,
citrus, tomatoes, peppermint, spicy or fried foods)

21
Q

Cleft Lip (CL) surgery

A

cheiloplasty: 10 – 12 weeks (approximate)

surgery for the lip can be done early, it needs no extra time for growth

22
Q

Cleft palate surgery

A

Repair/palatoplasty: 6 to 12 months (approximate)

has to wait to allow for more growth but needs to be done before it alters speech patterns

23
Q

Nursing Care Management for a child with a cleft lip, palate or both

A

 Interventions in assisting parents in accepting a birth defect
 Use of Haberman nipples for feeding, or a large syringe with soft, red rubber catheter
** More air will be taken in because of the cleft; so the infant will need burping often
 The infant with unrepaired cleft palate is at risk for aspiration with oral feeding

24
Q

Management of care: after cleft lip or palate surgery

A

 Promotion of surgical closure
 Prevention of complications
 Facilitate normal growth/development
 Speech issues are common with Cleft Palate even after initial repair

25
Q

Postoperative Care for Cheiloplasty

A 
Monitor airway
Protect the suture line 
pain management 
No suctioning
Proper positioning
26
Q

Postoperative Care for Palatoplasty

A

Monitor airway

Protect the suture line ATC pain management Soft diet

27
Q

Complications of Cleft Lip/Palate

A 
 Feeding difficulties
 Altered dentition
 Delayed or altered speech development
 Otitis media
 Excessive air intake – gagging, choking, regurgitation
28
Q

Promoting Nutrition in infant with cleft lip or palate

A

 Encourage breastfeeding
 Burping infant more often during feeding
 Monitor for aspiration
 Encourage Skin to Skin contact

29
Q

GERD signs

A 
Vomiting 
Colic -intense crying or fussiness 
Wheezing 
Failure to thrive 
Ear infections 
Abnormal posture 
Pneumonia
30
Q

After cleft lip or palate repair

A

Prevent crying
Logan bow
Pain medication
Elbow restraint

NO:
Suctioning 
Pacifier 
Nipple 
Hard food or items
31
Q

Feeding after repair

A

Haberman Feeders

Breck Feeders

Spoon to lips only
Syringes

Pigeon Feeders

32
Q

Preschooler nutrition needs

A 
Calcium daily 
 Iron daily
 fiber daily 
Fat intake
1000 – 1600 calories per day 
Limit juice-  Encourage water intake
33
Q

Infant nutrition needs

A

 Breast milk and formulas: 20 cal/oz
 Requirements met with multiple feedings
 Gain weight at rate of 1 oz per day for 1st 6 months

On Demand
 Hunger cues
 Bottle feed every 3-4 hours
 Breast feed every 2-3 hours, 10-20 min on each breast

34
Q

Weaning

A

 Individualized decision
 Encourage stopping bottle feeding between 12 to 15 months
 No spill sippy cups are not recommended for everyday use

35
Q

Diagnostic Evaluation of GERD

A 
 History and physical examination
 Upper GI series
 Esophageal pH monitoring
 Esophagogastroduodenoscopy (EGD)
 CBC and hemoccult

158 PEDS (14 decks)

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