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Nutritional Problems in Children Flashcards

1
Q

Most Common Food Allergies

A 
milk
eggs
wheat
peanuts
shellfish
seafood
soy
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2
Q

Mast-Cell Activation and Granule Release to the System leads to:

A
  • GI: increased peristalsis (v/d)
  • Airway: increase in inflammation, increase mucus buildup (rhinorrhea, congestion, sneezing)
  • Blood vessels: increased permeability > inflammation > swelling (usually facial)
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3
Q

Food Allergies: Clinical Manifestations

A
  • rashes
  • local inflammation
  • swelling of lips
  • hives

neuro s/sx: irritability, excessive crying, excessive sweating, hyperactivity, lethargy

anaphylaxis: wheeze, hives, swelling

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4
Q

Food Allergies: Dx

A
  • skin prick testing
  • eliminate suspected allergen trial
  • hypoallergenic diet (for 2 weeks then add food back in one at a time)
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5
Q

Hypoallergenic Foods

A 
rice 
rice products
pears
peaches
lamb
carrots
gelatin desserts
lettuce
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6
Q

Food Allergies: Primary Prevention

A

infant: slow introduction of solid foods

do not delay introducing allergenic foods unless strong family history of food allergies

breast milk, then formulas

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7
Q

Food Allergies: Tx

A
  • elimination/avoidance
  • allergy shots
  • peanut allergen immunotherapy trials: given orally (OIT), sublingually (SLIT) or epicutaneous (EPIT)
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8
Q

Celiac Disease

A

intolerance to gluten causing damage to villi in the small intestine

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9
Q

Gluten Product

A

wheat
rye
barley
oats

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10
Q

Celiac Disease: Etiology

A

autoimmune

genetic susceptibility unknown

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11
Q

Celiac Disease: Pathophysiology

A

chronic inflammation leading to destruction of the villi

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12
Q

Celiac Disease: Early Sx

A
  • steatorrhea
  • weight loss or poor weight gain
  • failure to grow
  • abdominal distention
  • FTT
  • anorexia
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13
Q

Celiac Disease: Late Sx

A
  • severe growth retardation
  • osteoporosis
  • osteomalacia
  • easy bruising
  • anemia
  • muscle wasting
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14
Q

Celiac Disease: Dx

A
  • fecal fat
  • biopsy
  • serological testing
  • trial of gluten free diet
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15
Q

Celiac Disease: Management

A
  • eliminate gluten from diet
  • TPM
  • Supplements
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16
Q

Celiac Disease: Nursing Dx

A
  • knowledge deficit
  • altered nutrition
  • fluid volume deficit
  • altered electrolytes
  • altered comfort
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17
Q

Lactose Intolerance

A

XXX

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18
Q

Lactose Intolerance: Dx

A

breath hydrogen test

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19
Q

Lactose Intolerance: Tx

A
  • supplement lactase

- eliminate lactose from diet

20
Q

Lactose Intolerance Nursing Considerations

A
  • skin care w/ increased stools (increased acid and enzyme content in stools)
  • teaching
21
Q

Lactose Intolerance Nursing Considerations

A
  • skin care w/ increased stools (increased acid and enzyme content in stools)
  • teaching
22
Q

Crohn’s Disease

A

an inflammatory bowel disease

  • chronic intestinal inflammation of unclear etiology
  • no known cure
23
Q

Ulcerative Colitis

A

an inflammatory bowel disease

  • inflammation w/ ulcer formation in the lining of the colon
  • cause is unknown
  • end of the colon (rectum) is generally involved
24
Q

Crohn’s Disease: Top S/Sx

A
  • abdominal pain
  • rectal bleeding
  • diarrhea
  • anorexia
  • weight loss
25
Crohn's Disease: Extraintestinal Manifestations
- arthritis - osteoporosis - primary scleorsing cholangitis (inflammation of bile ducts) - renal calculi - anemia - oral aphthous stomatitis - erythema nodosum (inflammation of fat cells under skin - causes tissue necrosis > ulcers and chronic wounds usually of the legs) - pyoderma gangrenosum
26
IBD: Dx
lab testing: - CBC - inflammatory markers: ESR, CRP - nutritional: protein, albumin, iron, zinc, magnesium, B12, fat-soluble vitamins - stool studies Serology tests: -IBD diagnostic panel Radiology: - abdominal x-rays - abdominal CT scan - MRE - Small bowel follow through Endoscopy: - upper endoscopy (EGD) - colonoscopy - video capsule endoscopy
27
IBD: Tx
Acute phase: - NPO - fluid/electrolytes or TPN - monitor bowel sounds and abdomen - monitor stool output - diet: clear to low-residue diet to high-protein, high calorie diet - vitamin supplementation: multivitamin, iron, folic acid Meds: - antibiotics - Aminosalicylates (5-ASAs): used to tx inflammation of the gut and prevent flair ups - Corticosteroids - Immunomodulators - Biologics Surgery (last resort): - UC: severe bleeding, toxic megacolon - CD: abscess drainage, fistula, obstruction, stricture, perforation
28
IBD: Priorities
- dehydration - blood loss - hemodynamics - infection
29
IBD: Evaluation
- pain assessments - improved stool output - weight gain
30
IBD: Goal of Tx
- decrease flare-ups | - improve pt quality of life
31
Enterobiasis (Pinworms): Source and Mode of Transmission
- infected humans (common in daycare and schools) - contaminated hands, food, and air - incubation period (2-6wk)
32
Pinworms: Clinical Manifestations
- intense itching - irritability - n/v - weightloss
33
Pinworms: Dx
- place cellophane tape on the anus which will pick up eggs or worms - stool for O&P
34
Pinworms: Tx
- anthelmintic (mebendazole):: 1 dose now and 1 dose in 2 wks - all family members are treated - wash clothes, towels, linens w/ hot water - vacuum - damp mop - good hygiene
35
Gastroenteritis: Cause
Dietary: overfeeding, new foods, milk too soon after diarrhea, too much fruit juice Meds: antibiotics, laxatives Toxic agents: heavy metals, organic phosphates ``` Viral (about 60%): -rotavirus -norwalk virus adenovirus -parvovirus ``` Bacterial: - Salmonella - shingella - campylobacter - e.coli - staph aureus Parastic: - giardia - cryptosporidium Other: - post-op - chemo
36
Gastroenteritis: Tx
- PO trial - BRAT diet - if dehydrated, NPO and IVF - NS bolus (20 mL/kg of crystalloid NS or LR) - antibiotics if bacterial etiology
37
Colic
XXX
38
Phenylketonuria (PKU)
birth defect that causes the amino acid phenylalanine to build up in the body -untreated can lead to brain damage, intellectual disabilities, behavior symptoms, seizures
39
PKU: Tx
strict diet w/ limited protein
40
PKU: Dx
tested a minimum of 24 hours after beginning milk (breast or formula) retested 7-10 days later to catch false negatives
41
PKU: Foods to Avoid
- meat - dairy products - dry beans - nuts - eggs
42
GERD: Sx
- chronic vomiting - FTT - Fussiness - esophagitis - aspiration
43
GERD: Dx
- history - x-ray - upper GI - EGD - Ph probe (GOLD STANDARD)
44
GERD: Management
- conservative tx - meds surgical: nissen fundoplication
45
Failure to Thrive (FTT): Organic FTT Cause
growth failure d/t acute or chronic disorder that interferes w/ nutrient intake, absorption, metabolism, or excretion or that increases energy requirements
46
FTT: Non-Organic Cause
- 80% w/ FTT do not have apparent organic disorder | - failure occurs b/c of environmental neglect (e.g. lack of food), stimulus deprivation, or both

Pediatrics (14 decks)

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