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Therapeutics Fall Semester P3 > Pediatric Nutrition-Israel > Flashcards

Pediatric Nutrition-Israel Flashcards

1
Q

T/F: Infants have a caloric reserve

A

False; NEED a constant calorie source

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2
Q

T/F: It is okay for an infant to be NPO

A

F; must give dextrose IV

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3
Q

Typical infant weight at birth (term)

A

2-4 kg

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4
Q

Weight _____ by month 6

A

Doubles

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5
Q

Weight _____ by month 12

A

Triples

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6
Q

Length of an infant will increase by ____% by month 12

A

50

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7
Q

Growth for a preschooler (2-6 y/o)

A

Growth slows, but still increases at a constant rate. Fat stores increase around 2 years old

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8
Q

Growth for a pt that is in middle childhood (7-10 y/o)

A

Steady growth
Girls > Boys

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9
Q

Growth for a pt in adolescence (11-18 y/o)

A

Begins before puberty and continues until growth is complete. Rate of weight gain increases
Boys > Girls

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10
Q

T/F: During a growth spurt, the growth matches the growth change in infancy

A

F; way more growth change in infancy

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11
Q

Which growth charts are used for which ages?

A

WHO for < 2 y/o
CDC for 2-20 y/o

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12
Q

T/F: Growth is NOT linear

A

True

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13
Q

Where do neonates expend most of their energy?

A

In the brain

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14
Q

What is malnutrition?

A

Excess OR deficiency in nutrient intake

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15
Q

What are we most concerned about for a patient that is chronically undernourished?

A

Refeeding syndrome

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16
Q

What is a Z-score?

A

Statistical analysis giving the NUMBER OF STANDARD DEVIATIONS away from the MEAN a value is

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17
Q

What does a Z-score of -4.2 indicate?

A

The patient is 4.2 standard deviations below the 50th percentile

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18
Q

Requirements to be considered failure to thrive (growth faltering)

A
  1. Weight crosses 2 major percentile lines
  2. Weight is below the 3-5th percentile
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19
Q

Acute causes of malnutrition

A

Child seriously injured, in ICU and needs TPN

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20
Q

Chronic causes of malnutrition

A

-Disorders (CF-cannot produce pancreatic enzymes)
-HF (using so much energy just to live life)

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21
Q

What are the 3 underlying causes leading to malnutrition?

A
  1. Inadequate caloric intake
  2. Inadequate absorption
  3. Excessive energy expenditure
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22
Q

As infants and children age, their calorie/kg requirement will ______.

A

Decrease

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23
Q

If there are no contraindications, how long should a mother exclusively breastfeed?

A

First 6 months
*WHO suggests up to 2 y/o

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24
Q

Advantages of breastfeeding for newborn

A
  1. Optimal nutrients
  2. Decreased risk of infection/immune-mediated diseases
  3. Psychologic/cognitive advantages (oxytocin production/bonding)
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25
Q

Advantages of breastfeeding for mother

A
  1. Decreased post-partum bleeding
  2. Return to pre-pregnancy weight more quickly
  3. Decreased risk of breast/ovarian cancer
26
Q

How many kcal per oz are in breast milk?

A

20 kcal/oz

27
Q

Breastfeeding contraindications

A

TB
HIV
T cell lymphotropic virus
Ebola
Illicit drugs
DRUGS THAT MOM IS TAKING

28
Q

2 main categories for maternal medications to avoid during breastfeeding

A
  1. Directly harm the infant (chemo; immunosuppressant)
  2. Reduce the milk supply (antihistamine bc dries things out)
29
Q

Characteristics of drugs that increase absorption into breast milk

A

-Non-ionized
-Small MW
-Low protein binding
-High lipid solubility
-Long half-life (sticking around more, so more likely to get into milk)
-Low Vd (doesn’t have many tissues to go to in mom. so it will go into breast milk)

30
Q

Indications for formula feeding

A

-Mothers who do not/cannot breast feed
-Infants with intolerance
-Maternal infection (HIV)
-Maternal chemo
-Infants failing to gain weight

31
Q

What is added to milk when we fortify it?

A

-Calories
-Minerals
-Vitamins
-Proteins

32
Q

How many kcal/oz when milk is fortified?

A

22-28 kcal/oz

33
Q

Term formulas contain ____ kcal/oz

A

19-20
Similar to human milk

34
Q

T/F: all formulas are the same

A

False; for example, some are thickened to help prevent GERD

35
Q

Typical feeding for term, healthy babies

A

6-9 times/day

36
Q

Typical feeding for baby breastfeeding

A

8-12 times/day

37
Q

Typical feeding for neonates

A

Q1-2H

38
Q

With time, frequency will go _____, but volume will go _____

A

down; up

39
Q

Which vitamin is cholecalciferol?

A

Vitamin D3

40
Q

How is cholecalciferol dosed?

A

In mcg or IU

41
Q

What is the conversion for IU to mcg for cholecalciferol?

A

400 IU = 10 mcg

42
Q

How much cholecalciferol should a premature neonate receive?

A

200 IU QD (5 mcg)

43
Q

How much cholecalciferol should a term infant who is fully/partially breastfed get?

A

400 IU QD (10 mcg)

44
Q

How much cholecalciferol should a term infant that is formula fed get?

A

200-400 IU QD up to 1000 ml/formula/day

45
Q

Should all infants get iron supplementation?

A

NO

46
Q

How much iron should a premature neonate get?

A

2 mg/kg/day elemental iron

47
Q

How much iron supplementation should a term infant with an iron deficiency get?

A

3 mg/kg/day elemental iron

48
Q

What is the common ferrous sulfate concentration?

A

75 mg/ml

49
Q

What is the common concentration of elemental iron?

A

15 mg/ml

50
Q

Steps for calculating iron

A
  1. Calculate dose based on pt weight and their requirement
  2. Determine the product (we use 75 mg/ml ferrous sulfate)
  3. Determine the ml needed of elemental iron (use the 15 mg/ml)
  4. Convert the elemental form back to salt form using the 75 mg/ml concentration
51
Q

Is supplementation of zinc routine?

A

No

52
Q

Initiating complementary foods

A

-Start ~6 months
-Try 1 new food Q4-5d
-Increase serving size gradually
-Emphasize all food groups
-NEVER put anything but breast milk/formula in bottle

53
Q

What should you never give to children < 1 y/o?

A

-Honey (may cause botulism)
-Cow’s milk
-Choking hazards
-Potential allergen (ex: if family member has PB allergy, give PB in clinic)

54
Q

Fluid requirements for pts up to 10 kg

A

100 ml/kg

55
Q

Fluid requirements for pts 10-20 kg

A

1000 ml + 50 ml/kg for every kg over 10 kg

56
Q

Fluid requirements for pts >20 kg

A

1500 ml + 20 ml/kg for every kg over 20 kg

57
Q

Required information to calculate feeding

A

-Age
-Preconceptual age if preterm
-Medical conditions
-Current weight
-# of feedings per day

58
Q

How many ml are in 1 ounce?

A

30 ml

59
Q

Steps to calculate feeding requirement

A
  1. Convert weight to kg
  2. Calculate caloric needs based on chart
  3. Calculate volume of formula (given in situation)
  4. Calculate total fluid requirements (minimum fluid goal is 100 ml/kg)
60
Q

Calculating feeding requirements for pts who are failure to thrive (growth faltering)

A

Follow the same steps as for a term patient, but use the 50th percentile weight, NOT the patient’s current weight

61
Q

Short-term routes for non-oral nutrition

A

NG, ND, NJ, orogastric tube

62
Q

Long-term routes for non-oral nutrition

A

PEG, PEJ, surgical jejunostomy, G-tube

Therapeutics Fall Semester P3 (7 decks)

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