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PHM 704 Pediatrics and Geriatrics > Pediatric Growth and Nutrition > Flashcards

Pediatric Growth and Nutrition Flashcards

1
Q

Neonate

A

</=28 days old

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2
Q

Premature

A

</= 37 weeks

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3
Q

Full-term

A

38-41 weeks

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4
Q

Post-term

A

> /= 42 weeks

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5
Q

Infant

A

> 28 days-12 months

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6
Q

Child

A

1-12 years

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7
Q

Toddler

A

1-4 years

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8
Q

Early school age

A

5-7 years

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9
Q

Older school age

A

8-12 years

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10
Q

Adolescent

A

13-17 years

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11
Q

Adult

A

> /= 18 years

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12
Q

Extremely low birth weight

A

<1000 grams

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13
Q

Very low birth weight

A

1000-1499 grams

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14
Q

Low birth weight

A

1500-2499 grams

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15
Q

Normal birth weight

A

2500-3999 grams

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16
Q

High birth weight

A

> 4000 grams

17
Q

Growth charts used for children

A

<2 years: WHO
>/= 2 years: CDC

18
Q

Markers of growth & development

A

Weight, length/height, head circumference, weight-for-length, BMI
Growth charts
Motor skills (gross and fine, assessment recommended at every well-check)
Cognitive development (assessment recommended at every well-check)

19
Q

Weight assessment

A

Underweight:
<3: Weight for length < 5th percentile
>/=2: BMI for age < 5th percentile

Risk of overweight:
>2: BMI for age 85th-95th percentile

Overweight:
<3: Weight for length > 95th percentile
>/=2: BMI for age > 95th percentile

Obese:
2-18 years: BMI >/= 30 kg/m2 or BMI for age >/= 95th percentile

20
Q

Weight gain in term infants

A

20-30 g/day
Double birth weight by 4 months of age
Triple birth weight by end of 1st year of life
Neonates may lose weight in first days of life, but should regain it within the first to second week of life

21
Q

Growth in length for infants

A

Increases by 50% in first year of life

22
Q

Failure to thrive

A

Weight-for-age < 5th percentile on multiple occasions

23
Q

Causes of FTT

A

Inadequate caloric intake, inadequate caloric absorption, excessive caloric expenditure

24
Q

Treatment of FTT

A

Breastfed infants: breastfeeding more often, lactation support, formula supplementation
Formula-fed infants: concentrated formulas
Avoid juice or cow milk consumption, add rice cereal to foods

25
Q

How many calories in breast milk?

A

20 kcal/oz

26
Q

Breastfeeding recommendations

A

Exclusive breastfeeding for first 6 months of life, with support for continued breastfeeding for the first year and beyond

27
Q

Benefits of breastfeeding

A

Decreased URI (AOM), UTI, necrotizing enterocolitis, meningitis, diarrhea, sepsis, SIDS, diabetes, cancer, asthma, and obesity

28
Q

Vitamin D requirement

A

400IU per day, starting first few days of life

Breastfed/partially breastfed infants taking < 1000 mL/day of Vitamin D-fortified milk (human milk offers < 25 IU/L of Vitamin D)
All non-breastfed infants and older children ingesting < 1000mL/day of Vitamin D-fortified formula, food or milk
Adolescents not obtaining 600 IU for Vitamin D through fortified milk

29
Q

Fluoride requirement

A

0.5 mg/day in infants > 6 months
Supplementation not needed in first few months of life
Only needed for exclusively breastfed infants
Children should not use fluorinated toothpaste until 2 years old

30
Q

Iron requirement

A

Breastfed: Full term = 1 mg/kg/day from 4-12 months, pre-term = 2 mg/kg/day from 1-12 months
Formula fed: Full term = fortified formula containing Fe 4-12 mg/L until 12 months, pre-term = additional 1 mg/kg/day to bring total daily dose to 2 mg/kg/day

31
Q

Diet for pediatric patients

A

Solids start ~ 4-6 months of age
Single ingredient, started 1 week apart
Cereals: rice, barley, oatmeal
Veggies, fruits, meats start at 8-9 months

Toddlers
Regular diet + whole milk until 2 years of age
Watch fruit juice: Limit to 4-6 ounces per day or avoid entirely. Make a part of a meal/snack, not for diarrhea management.

32
Q

Indications for specialized nutrition support

A

Enteral:
Premature neonates under 32-34 weeks gestational age
Infants too sick to breastfeed or bottle feed
Patients who are mechanically ventilated
Pediatric patients whose needs cannot be met by the oral route

Parenteral:
Nutritional needs cannot be met by EN or when the GI tract is not functioning (e.g. short bowel syndrome

33
Q

Enteral feeding tubes and medication administration considerations

A

Formulations: Avoid enteric coated and modified release products, viscous products

Interactions: Avoid mixing medications with enteral feeding formulas

34
Q

Safety considerations of specialized nutrition support

A

Enteral: Contamination of EN formulations and enteral feeding misconnections

Parenteral: Calcium phosphate precipitation, contamination of PN formulation, over or under dosing of dextrose, omission of dextrose, iron overload, trace element overdoses, overdose of electrolytes, and heparin overdose

PHM 704 Pediatrics and Geriatrics (21 decks)

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