NUTR 650 Module 3 Study Guide
NUTR 650 Module 3 Study Guide NUTR 650
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This 6 page Study Guide was uploaded by Valerie Nesom on Monday March 7, 2016. The Study Guide belongs to NUTR 650 at University of New Hampshire taught by Dr. Rielly in Spring 2016. Since its upload, it has received 35 views. For similar materials see Lifecycle Nutrition in Nutrition and Food Sciences at University of New Hampshire.
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Date Created: 03/07/16
Module 3: PreExam Homework (Infancy) Spring 2016 Go to the content area (PreExam Homework) and open PreExam Homework (Module 3) Infancy Folder. Open file entitled: PreExam HomeworkWord Document (Module 3) and download onto your own computer. Do not open the Infancy: PreExam Homework Assignment until you have answered all the questions in the word document. Answer all the questions in the word document before you submit your assignment into Blackboard. This is an openbook format. You may use any sources you would like to answer these questions; text, lecture notes, other books, etc. I would advise against using the Internet as the information there is not always reliable and it will result in lost points. In order to receive credit all answers to the definitions must apply directly to the Infancy Module. Please use your own words when answering the questions. After you have answered all the questions go back onto Blackboard. Open Infancy: PreExam Homework Assignment and either type in or cut/paste in your answers from a word document on your computer. You can submit your answers only once. After you submit you cannot go back in and change your answers, as you will be locked out of the assignment. If you have technical difficulties and get locked out of the assignment you need to email Dr. Reilly and Sarah Jacobson immediately as we are the only ones who can unlock the assignment for you. Unlocking the assignment will result in lost answers. Good Practice: Please do not wait until the hour before the assignment is due to submit your homework. At that point technical difficulties may be impossible to fix and the result will be a zero on this assignment. These essays are to be completed on your own with no communication with others. Any violation of the academic contract will result in a zero in the course. This assignment is due no later than Thursday, March 31, 2016 at 9 pm. After this date and time the assignment will be removed from Blackboard. Questions 1. APGAR. (9 points) a. What is APGAR and what is its purpose? b. List and describe the five components of the APGAR. c. Describe how the APGAR is scored and what each of the scores indicate. APGAR is a rating given to a newborn 1 minute and then again at 5 minutes after they are delivered. Its purpose is to test for how the newborn handled the birth process and 1 how the newborn is handling and reacting to the outside environment. The newborn was very comfortable in the controlled environment of the mother’s womb and it’s important to see how the newborn’s body is reacting to the new change. The APGAR stands for five components: activity (muscle tone), pulse (heart rate), grimace (reflex, irritability), appearance (skin tone) and respiration (breathing). The scoring is based on a scale of 0 to 10. Each of the five categories is scored with a 0, 1, or 2 based on certain criteria for each. For example, for the first category, activity, a score of 2 would be given if the newborn is demonstrating spontaneous movement, a score of 1 would be given if the newborn’s arms and legs flexed but with little movement and a score of 0 would be given if there was no movement from the newborn. After each category is scored, add up the total amount. The goal is for the newborn to receive a score of 10, which is rare. A score of 8 to 10 indicates that the newborn is in good health, a score of 5 to 7 indicates that the newborn is suctioning and is experiencing difficulty breathing, and a score equal to or less than 4 indicates immediate action but be taken; resuscitation. The overall score taken at 1 minute is usually lower than the score taken at 5 minutes and the APGAR test is always taken at both the 1 minute and 5 minute post delivery marks. 2. As discussed in lecture, what are the four physical (internal) maturation milestones that need to be in place before an infant can be introduced to solids? (8 points) The four physical (internal) maturation milestones are: 1) the infant’s kidneys must be ready to manage and handle a large renal solute load, 2) there must be a sufficient supply of enzyme activity, 3) a large enough intestinal surface area is required and 4) the mucosal barrier in the infant’s stomach needs to be developed in order for an infant to be introduced to solids. 3. List four distinct signs that indicate that an infant is dehydrated. (8 points) Four distinct sings that indicate that an infant is dehydrated include: the infant’s skin isn’t going back into place when slightly pinched; the skin isn’t elastic and is tenting, the infant has had a dry diaper for more than 3 hours, the infant’s mouth is dry and has dry mucous membranes and lastly the infant seems very lethargic and not alert/ as awake as usual. 4. NEONATAL JAUNDICE (15 points) a. Define neonatal jaundice. b. What are the signs and symptoms of neonatal jaundice? c. What is the difference between pathologic jaundice and physiologic jaundice in newborns? d. What is the physiological mechanism the body uses to resolve this condition? e. What are the recommended treatments for this condition? f. What are the possible consequences for an infant who is not treated for this condition? 2 a. Neonatal jaundice is a condition that can occur to infants where there is a buildup of bilirubin in the infant’s blood (hyperbilirubinemia). b. The sings and symptoms of this condition include yellowing of the skin and a high level of bilirubin the blood. c. Pathologic jaundice occurs right after the infant is born. It indicates that there could be a possible error in metabolism or red blood cell dysfunctions where bilirubin quickly elevates in the infant’s blood. Physiologic jaundice occurs 24 hours after the infant is born. It isn’t seen as a danger to the infant and is very normal. The main difference between pathologic and physiologic jaundice is that pathologic is more serious and physiologic is a normal condition seen in newborns that isn’t serious. d. The physiological mechanism the infant’s body uses to resolve this condition is the liver making the insoluble bilirubin soluble. Since the oxygen needs of the infant are much lower now, red blood cells are destroyed causing a buildup of bilirubin, which can’t breakdown. The liver then over time makes the bilirubin soluble in order for it to be excreted through bile, the intestines and stool. e. The recommended treatments include phototherapy, which makes the bilirubin soluble and/ or blood transfusions. Usually, the infant resolves the issue by itself within a few days to one week with no help of treatment needed f. If the jaundice is left untreated, there are dangerous consequences. Brain damage could occur, cerebral palsy, hearing loss, and lowered intellectual functioning of the brain. 5. Baby Courtney is 8monthsold and weighs 19 pounds. (9 points) a. Approximately how many calories should Courtney consume each day? (Use the EER in your calculation). b. How many grams of protein should Courtney consume each day? c. How many mg of calcium does she need each day? EER=[89 X 8.64kg – 100]+22] EER= 690.96 calories Courtney should consume approximately 690.96 calories per day. Courtney needs 1.5g/kg/day Kg=19lb/2.2 Kg= 8.64kg 8.64kg x 1.5 = 12.96 grams Courtney should consume 12.95 grams of protein per day. Courtney should consume 270mg of calcium per day. 6. INTRODUCTION OF SOLID FOODS: (12 points) 3 a. What are four ways a mother can tell if her infant is ready to start eating solid foods? b. What is the recommended sequence of foods and beverages introduced to infants and what is the rationale for introducing each of these foods/beverages at that point in time? c. What are the recommended changes in food textures during the first year of life? Four ways a mother can tell if her infant is ready to start eating solid foods are: if her infant has doubled its birth weight, infant opens its mouth for a spoon of food, the infant can keep its head upright and the infant can sit up with little support. The recommended sequence of foods and beverages introduced includes: 1. Iron fortified cereals at 6 months: it’s best to start with the least allergenic food, which is rice cereal, on a spoon in 12 Tbsp. portions mixed with a little breast milk or formula. 2. Vegetables at 6 months: its best to introduce vegetables before fruits in order to increase acceptance rates of choosing to consume them. It might possibly take 810 exposures of a vegetable before the infant will consume it. 3. Fruit at 6 months: offer the infant commercial baby and infant formula that fortified with vitamin C to help with iron absorption. It’s must easier for the infant to accept them when they have a small amount of added sugar or corn syrup, especially with tart fruits. 4. Yogurt at 8 months: it is a great source of calcium and protein for the infant. Commercial infant yogurt is lower in sugar than regular. If you buy a plain yogurt add a little bit of baby fruit in it to increase acceptance. 5. Meat at 79 months: it’s best to start with lamb since it’s the least allergenic. Meat is the least accepted food by infants. Combining meat with a vegetable is a good option since the combination is lower in protein. 6. Fruit juice at 1 year: apple juice is a good juice to start with since it’s the least allergenic. It’s best to use an unsweetened juice and to dilute it at first. Always give in a cup in moderation and is only needed if the infant isn’t eating fruit. The recommended changes in food textures during the first year of life are introduced in the following sequence: strained or purred, lumpy, chopped and table foods at one year. You should gradually introduce textures throughout this first year of the infant’s life. 7. FAILURE TO THRIVE: Complete the following table to describe FailuretoThrive in infants and children: (12 points) Type Cause/s Symptoms Treatment 4 OrganicFailureto Caused by an The child is To diagnose the Thrive underlying medical lethargic, passive, cause, such as condition, such as developmentally malabsorption malabsorption immature. syndrome and treat syndrome or the cause. Could cerebral palsy. need nutrition therapy. NonOrganic No known medical Child is passive, Depends on Failure to Thrive condition for the temperamental, condition and extent cause. It relates to a developmentally of the situation. social or behavioral immature, delayed Family counseling, dysfunction. development, low social worker for rate of growth, has family, nutrition hanging skin folds therapy. seen on the arms. Definitions: In one or two sentences define the following terms. (Please make sure your answers apply to the Infancy Module). (3 points each) 8. Thermal stress: is a normal condition that occurs within the first 24 hours after the infant is born due to the new outside environment the infant is now in. The infant experiences a 610% loss in birth weight that is regained within the next 10 days. The weight loss is due to fluid loss, breakdown of tissue and adjustments to the new environment. 9. Milk anemia: a type of iron deficiency anemia that can occur particular in older children. It happens when cow’s milk, which is low in iron, is the child’s main food source, and doesn’t eat a lot of other foods, can become anemic. 10. Hemolytic disease: it is a blood disorder of the infant that could possibly be life 5 threatening if not treated. It occurs in a Rh mother’s second pregnancy if there has been a mixing of blood from her first pregnancy, where the infant was Rh+, and the mother builds up antibodies against the Rh+ factor. In the second pregnancy, her antibodies cross the placenta, which causes a problem if her fetus is Rh+, causing the fetus’s red blood cells to rupture. 11. Fontanel: it is a soft spot on top of the baby’s head. The ossification of the skull bones are not yet completely formed and creates a space in between the skull bones. 12. pSGA: it stands for proportionately small for gestational age and is a measurement taken to determine fetal growth. It is a measurement of weight, length, and head circumference ≤10% that indicates that there was malnutrition throughout the mother’s pregnancy. 13. Nonnutritive suck: is a feeding difficulty seen in premature infants due to the infant’s underdeveloped motor skills. They have a hard time sucking on the nipple to receive milk resulting in fatigue, satiety, unable to handle large amounts of milk at once etc. 14. Division of Responsibility: a term developed by an RD named Ellyn Statter. It states that as parents and caregivers, we have a responsibility to provide nutritious food, love, support, and to listen to our baby. It is the responsibility of the baby to chose to eat food or not. 15. Infant mortality: is death of the infant that happens within the first year of life. 16. Bilirubin: it is a byproduct from the breakdown of hemoglobin. It is made soluble by the liver and is excreted from the body through bile, the intestines and stool. 6
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