201exam2studyguidePDF.pdf NHM 201
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This 27 page Study Guide was uploaded by Regan Dougherty on Thursday October 22, 2015. The Study Guide belongs to NHM 201 at University of Alabama - Tuscaloosa taught by Denise DeSalvo in Summer 2015. Since its upload, it has received 93 views. For similar materials see Nutrition Through the Lifecycle in Nutrition and Food Sciences at University of Alabama - Tuscaloosa.
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Date Created: 10/22/15
test date 102715 NHM 201 Exam 2 Study Guide This exam covers Chapters 8 13 Chapter 8 Infant Nutrition Assessing Newborn Health APGAR Appearance skin color Pulse Grimace response reflex Activity and muscle tone Respirations breathing rate effort each is scored from O 2 and the total score ranges from 1 10 Standard Newborn Growth Assessment considers weight length head circumference appropriate for gestational age AGA small SGA IUGR large LGA FULL TERM INFANTS infants born between 37 and 42 weeks of gestation PRETERM INFANTS before 37 weeks INFANT MORTALITY death that occurs within the first year of life EPSDT The Early Periodic Screening Detection and Treatment Program is a part of Medicaid and provides routine checkups for lowincome families INTRAUTERINE GROWTH RETARDATION IUGR fetal undergrowth from any cause resulting in disproportionality in weight length or weightforIength percentiles for gestational age Infant Development REFLEX an automatic unlearned response that is triggered by a specific stimulus ROOTING REFLEX action that occurs if one cheek is touched resulting in the infant s head turning toward that cheek and the infant opening his mouth SUCKLE a reflexive movement of the tongue moving forward and backward earliest feeding skill Motor development is top down head first lower legs last Motor Skills Timeline test date 102715 1 month chin up 2 months chest up 3 months reach and miss 4 months sit with support 5 months sit on lap grasp object 6 months sit on high chair grasp dangling objects 7 months sit alone 8 months stand with help 9 months stand holding furniture 10 months creep 11 months walk while led 12 months pull to stand by furniture 13 months climb stairs 14 months stand alone 15 months walk alone SENSORIMOTOR an early learning system in which the infant s senses and motor skills provide input to the central nervous system putting sight and physical together Digestion GI tract is still being established colic diarrhea constipation GER GASTROESOPHAGEAL REFLUX GER movement of the stomach contents backward into the esophagus due to stomach muscle contractions Parenting Development Parents need to learn to recognize when baby wants to eat be able to distinguish between different cries hungry vs dirty diapers Factors that influence the rate of passage through an infant s body test date 102715 osmolarity of foods OSMOLARITY measure of the number of particles in a solution which predicts the tendency of the particles to move from high to low concentration colon bacterial flora water and fluid balance in the body Energy and Nutrient Needs Factors that affect energy needs weight growth rate sleepwake cycle temperature and climate physical activity metabolic response to food health status and recovery from illness Energy Needs highest of any stage of life birth 6 months 108 kcalkg 6 12 months 98 kcalkg Protein Needs Protein needs are similar to that of energy needs but are also influenced by body composition Every time weight increases protein needs increase birth 6 months 22gkgday 6 12 months 16 gkgday Fat Needs no specific intake level for infants Breastmilk contains about 55 calories from fat Cholesterol is needed for gonad and brain development Breastmilk contains short medium and longchain fatty acids SHORTCHAIN FATS carbon molecules that provide fatty acids less than 6 carbons long as products of energy generation from fat breakdown inside cells not usually found in foods test date 102715 MEDIUMCHAIN FATS carbon molecules that provide fatty acids with 6 1O carbons also not usually found in foods Short and medium are easier to digest LONGCHAIN FATS carbon molecules that provide fatty acids with 12 or more carbons commonly found in foods The metabolic rate is highest for the first 6 months because the baby has much more muscle than fat MITOCHONDRIA intracellular unit in which fatty acid breakdown takes place and many enzyme systems for energy production inside cells are regulated Other NutrientsNonnutrients fluoride 01 05 mgday depending on age too much may cause tooth discoloration vitamin D 400 lUday sodium 120 200 mgday fiber no recommendations lead none may be toxic Physical Growth Assessment Full Term lnfant 55 85 lbs 0 185 215 in Preterm lnfant LBW 55 lbs VLBW 3 lbs 5 oz ELBW 2 lbs 3 oz Newborns grow faster than any other time of life test date 102715 Growth depends on nutritional status health status environment Measuring Growth Accurately in Infants use measuring equipment that was calibrated recently confirm the scale is on zero before starting make sure the infant is not holdingwearing anything that adds weightlength confirm the position of the infant for length measurements the infants eyes are looking straight up and the head is in midline touching the headboard neither hips nor knees are bent heel is measured with foot flat against the foot board head circumference measure is at the widest part of the head Growth Charts World Health Organization what is normal for children around the world O 24 months blue for boys and pink for girls CDC growth charts are for children 2 years or older based on US population Feeding in Early Infancy Recommendation breast milk exclusively for first 6 months and continue through first year second choice commercial infant formula for sickpreterm babies NO COW MILK IN INFANCY anemia may result from GI bleeding low absorption of calcium and phosphorous displacement of ironrich foods baby gets full on milk and may not eat the foods it should be eating test date 102715 Standard infant formula provides 20 kcaloz preterm formula provides 22 24 kcaloz As the infant grows older more formulamilk is consumed and less feedings occur in a day Development of Infant Feeding Skills Infants have an inherent preference for sweet taste must acquire taste for other flavors 4 6 weeks reflexes fade infant begins the purposely signal wants and needs Introduction of Solid Foods Food offered from a spoon stimulates mouth muscle development After 6 months use infant spoon to offer small portions 1 2 tbspmeal of semisoft food oncetwice a day infant should not be overly tired or hungry use small spoon with shallow bowl allow infant to open mouth and extend tongue place spoon on front of tongue with gentle pressure avoid scraping spoon on infant s gums pace feeding to allow infant to swallow first meals may be 56 spoons over 10 minutes Wait 3 5 days before adding something new Sequence iron fortified rice and other cereals wheat last single fruitsvegetables eggs wheat close to 1 year of age table foods still sotmashed maybe semilumpy about 8 10 months test date 102715 Child should be sitting upright Improper positioning may cause issues including ear infections The person feeding the baby should be at eye level with the baby Fluids Babies get adequate nutrition from breast milk may need extra water if in a very hot climate baby can get dehydrated if sick vomitingdiarrhea Offer waterjuice from cup after 6 months no sippy cups Open cup drinking skills encourage speech development Feeding readiness cues watching food in anticipation of eating tight fists reaching for spoon irritation if feeding too slowstops temporarily playing with food full slow intaketurning away full stop eatingspit out food full WEANING discontinuation of breastfeeding or bottlefeeding and substitution of food for breast milk or infant formula HYPOALLERGENIC foods or products that have a low risk of promoting food or other allergies Inappropriate and Unsafe Food Choices hot dog pieces popcornpotato chips hard candy jelly beans peanuts other nuts chunks of peanut butter whole grapesraisins uncut stingy meats sausage sticky foods ex marshmallows gum and gummy textured candies hard raw fruits or vegetables ex apples green beans Infant Food Preferences Allow multiple trials of a food before you decide the baby doesn39t like it test date 102715 learn based on experience with food Breast milk contains flavor of foods the mother eats The baby may get used to these flavors What we eat in infancy sets the stage for whathow we eat as adults Nutrition Guidance Supplements fluoride recommended if the family lives in a place that does not provide fluoridated water or if breast milk is the only form of nutrition after 6 months iron 1 mgkg per day is recommended if breast milk is the only form of nutrition at 4 months for term infants until diet provides this amount of iron 2 mgkg per day are recommended starting at 1 month until 12 months if breast milk is the only form of nutrition B12 recommended if mother is a vegan vitamin D 400 IUday recommended if breast milk is the only form of nutrition Common Nutritional Problems and Concerns FAILURE TO THRIVE FTT condition of inadequate weight or height gain thought to result from an energy deficit whether or not the cause can be identified as a health problem Organic medically derivedsome sort of medical condition vs Nonorganic environmental DEVELOPMENTAL DISABILITIES general term used to group specific diagnoses that limit daily living and functioning and occur before age 21 COLIC a condition marked by a sudden onset of irritability fussiness or crying in a young infant between 2 weeks and 3 months of age who is otherwise growing and healthy associated with GI problemsnot tolerating formula Irondeficiency anemia Diarrhea Constipation test date 102715 Baby Bottle Caries parents put a child to sleep with a bottle containing juice water with sugar causing the child s teeth to rot possible issues with adult teeth formation Food AllergiesIntolerances allergic to a protein Lactose Intolerance CrossCultural Considerations Vegetarian Diets Infants receiving well planned vegetarian diets grow normally may need 812 D possibly iron and zinc Nutrition Intervention for Risk Reduction GALACTOSEMIA a rare genetic condition of carbohydrate metabolism in which a blocked or inactive enzyme does not allow breakdown of galactose causing serious illness in infancy HYPOTHYROIDISM condition in which thyroid hormone is not produced in sufficient quantities interfering with growth and mental development if untreated in infants Chapter 9 Infant Nutrition Conditions and Interventions know low birth weight very low birthweight and extremely low birth rate FETAL DEATH STILLBIRTH death that occurs before complete expulsion from the mother after 20 weeks or more of gestation and the fetus does not breathe or have a heartbeat DOWN SYNDROME condition in which 3 copies of chromosome 21 occur resulting in lower muscle strength lower intelligence and greater risk for overweight SEIZURES condition in which electrical nerve transmission in the brain is disrupted resulting in periods of loss of function that vary in severity Concerns Growth slowfast weight gain test date 102715 slow gain in length disproportionate weight to height ratio unusual growth pattern with plateaus change in brain size head circumference size change in skeletonorgans Nutritional Adequacy calorie needs are higherlower nutrient needs may differ higherlower vitamins and minerals Feeding mouthoral cavity and GI tract are these developed enough to consume food through the mouth or do they need a hydrolyzed diet appetite suppression maybe due to medications poor interaction between infant and parent postureposition timing of foods and beverages poor food choicesinstructions Energy and Nutrient Needs 108 kcalkg 1O infant with Down syndromespina bifida may need less premature 120 kcalkg Caloric needs may be as high as 180 kcalkg for recovery ex surgery Needs could be increased because of fever infection temperature regulation recovery from surgery test date 102715 Protein Needs 152 gkg if GI is functional recoveringpremature infants 3 35 gkg lower for some circumstances generally correlate with calories may be required as single amino acids or hydrolyzed protein if there are digestion issues Fat Needs higher for most infants up to 55 of total kcal Lack of pancreaticliver enzymes my require substitution of shorter chain fatty acids may supplement alphalinolenic alphalinoleic DHA ARA MCT these help the central nervous system MCT OIL a liquid form of fat used to boost energy composed of medium chain triglycerides VitaminsMinerals required in greater amounts for some circumstances DRls are a good starting point but are meant for healthy term infants Limiting nutrients calcium iron B12 vitamin D fluoride Human milk fortifiers and preterm formulas provide concentrated nutrients in small volumes CATCHUP GROWTH period of time shortly after a slow growth period when the rate of weight and heigh gains is likely to be faster than expected for age and gender HYPOCALCEMIA condition in which body pools of calcium are unbalanced and low levels are measured in blood as a part of a generalized reaction to illnesses Growth The body composition of infants born preterm is not the same as that of term infants in part because these infants have missed part of the third trimester when fat is added rapidly 12 test date 102715 Body fat buildup is a sign of recovery from preterm delivery There are some specialty growth charts for diagnosisspecific circumstances Use the standard chart for birthweight gt 2500 g born at 35 37 weeks MICROCEPHALY small head size for age and gender as measured by centimeters or inches of head circumference MACROCEPHALY large head size for age and gender Nutrition for Infants with Special Healthcare Needs DEVELOPMENTAL DELAY conditions represented by at least a 25 delay by standard evaluation in one or more areas of development AUTISM condition of deficits in communication and social interact with onset generally before age 3 in which mealtime behavior and eating problems occur along with other behavioral and sensory problems Severe Preterm Birth and Nutrition cannot nurse require respirator alternative feeding routes GI problems NUTRITION SUPPORT provision of nutrients by methods other than eating regular foods or drinking regular beverages such as directly accessing the stomach by tube or placing nutrients into the bloodstream PARENTERAL FEEDING delivery of nutrients directly to the bloodstream ENTERAL FEEDING method of delivering nutrients directly to the digestive system NECROTIZING ENTEROCOLITIS NEC condition with inflammation or damage to a section of the intestine with a grading from mild to severe ORALGASTRIC FEEDING a form of enteral nutrition support tube placement from the mouth to the stomach TRANSPYLORIC FEEDING TP form of enteral nutrition support tube placement from the nose or mouth into the upper part of the small intestine GASTRONOMY FEEDING form of enteral nutrition support tube placement directly into the stomach bypassing the mouth through a surgical procedure that creates an opening through the abdominal wall and stomach 13 test date 102715 JEJUNOSTOMY FEEDING form of enteral nutrition support tube placement directly into the upper part of the small intestine Infants with Congenital Anomalies and Chronic Illness CONGENTIALANOMALY condition evident in a newborn that is diagnosed at or near birth usually as a genetic or chronic condition ANENCEPHALY condition initiated early in gestation of the central nervous system in which the brain is not formed correctly resulting in neonatal death DIAPHRAGMATIC HERNIA displacement of the intestines up into the lung area due to incomplete formation of the diaphragm in utero TRACHEOESOPHAGEALATRESIA incomplete connection between the esophagus and the stomach in utero resulting in a shortened esophagus CLEFT LIP AND PALATE condition in which the upper lip and roof of the mouth are not formed completely and are surgically corrected resulting in feeding speaking and hearing difficulties in childhood MAPLE SYRUP URINE DISEASE rare genetic condition of protein metabolism in which breakdown byproducts build up in blood and urine causing coma and death if untreated Chromosome 220112 Deletion Syndrome DiGeorge Syndrome 22q11 microdeletion condition in which chromosome 22 has a small deletion resulting in a wide range of heart speech and learning difficulties Feeding Problems Preterm fatigue low volume tolerance more irritable less able to cue needs Signs of feeding problems lt 6 months hard time suckinglatching on milk runs out hungry all the time not waiting in between feeding extended feeding times not swallowing gt 6 months poor head control resist spoon feeding drinks from bottle but rejects baby food does not put things in mouth resists textures fails to give cues Nutrition Interventions assess growth more frequentlymore in depth test date 102715 monitor intake by diet analysis change how oftenwhat is being fed adjust timing of feedings as needed adjust feeding position increase nutrient density provide parent educationsupport observe parentchild interactions adjust guidelines to the ability of the infant regardless of age what does the child needwhat is their ability Nutrition Services Chapter 10 Toddler and Preschooler Nutrition Tracking Toddler and Preschool Health GROWTH VELOCITY the rate of growth over time TODDLERS children between the ages of 1 and 3 years rapid increase in gross and fine motor skills GROSS MOTOR SKILLS development and use of large muscle groups as exhibited by walking alone running walking up stairs riding a tricycle hopping and skipping FINE MOTOR SKILLS development and use of smaller muscle groups demonstrated by stacking objects scribbling and copying a circle or square PRESCHOOLAGE CHILDREN children between the ages 3 and 5 who are not yet attending kindergarten Normal Growth and Development Reduced intakeslower growth in toddlerpreschool stage than infancy How to Measure Growth Toddlers under 2 years weigh without clothes or diaper determine recumbent length 14 15 test date 102715 RECUMBENT LENGTH measurement of length while the child is lying down Children over age 2 years weigh with light clothing measure stature with no shoes standing STATURE standing height CDC growth charts are gender and age specific BODY MASS INDEX appropriate to use for gt 2 years old fluctuates through childhood look at percentiles on growth charts BMI gt 85 to 95 indicates overweight BMI gt 95 indicates obesity BMI lt 5 indicates underweight Physiological and Cognitive Development Cognitive more interactive vocabulary expands increased feeding skills need for both independence and ritualsroutine Feeding Behavior diminished appetite decreased interest in food is normal toddlersized portions 1 tbsp of food per year of age Toddlers have the innate ability to adjust caloric intake to meet caloric needs This ability diminishes over time Nutrition experts should be able to identify parental behaviors that interrupt that ex clean your plate PRELOADS beverages or food such as yogurt in which the energy macronutrient content has been varied by the use of various carbohydrate and fat sources test date 102715 Parents are responsible for what is eaten and the environment in which food is offered when and where Children are responsible for how much they eat and whether they eat a particular meal or snack Energy and Nutrient Needs EER estimated energy requirement These formulas to calculate caloric needs will be given on the test Protein 1 3 years 11 gkg 4 8 years 095 gkg Vitmins and Minerals Iron and zinc may be a concern because the children re not eating large quantities yet Iron and zinc are found in red meat so it could be an issue of socioeconomic status as well Calcium is a concern because of bone health 300 mg of calcium in an 8 oz glass of milk ANEMIA a reduction below normal in the number of red blood cells per cubic mm in the quantity of hemoglobin or in the volume of packaged red blood cells per 100 mL of blood occurs when balance between blood loss and blood production occurs Iron deficiency anemia results in delays in cognitive development and behavioral disturbances HEMOGLOBIN a protein that is the oxygencarrying component of red blood cells A decrease in hemoglobin concentration in red blood cells is a late indicator of iron deficiency HEMATOCRIT an indicator of the proportion of of whole blood occupied by red blood cells A decrease in hematocrit is a late indicator of iron deficiency 16 test date 102715 Vitamin and mineral supplements are only needed in special situations Common Nutrition Problems EARLY CHILDHOOD CARIES ECC the presence of one or more decayed missing or filled tooth surfaces in any primary tooth in a child 71 months of age oryounger causes bedtime bottle with juicemilk streptococcus mutans sticky carbohydrate foods prevention fluoride FLUOROSIS permanent white or brownish staining of the enamel of teeth caused by excessive ingestion of fluoride before teeth have erupted FOOD SECURITY access at all times to a sufficient supply of safe nutritious foods Prevention of NutritionRelated Disorders ADIPOSITY FOR BMI REBOUND a normal increase in body mass index that occurs after BMI declines and reaches its lowest point at 4 6 years of age Dietary and Physical Activity Recommendations 60 minutes of physical activity is recommended each day VEGAN DIET the most restrictive of vegetarian diets allowing only plant foods may need some supplements MACROBIOTIC DIET this diet falls between semivegetarian and vegan diets and includes foods such as brown rice other grains vegetables fish dried beans spices and fruit Chapter 11 Toddler and Preschooler Nutrition Conditions and Interventions Who Are Children With Special Health Care Needs CHILDREN WITH SPECIAL HEALTH CARE NEEDS a general term for infant and children with or at risk for physical or developmental disabilities or chronic medical conditions from genetic or metabolic disorders birth defects premature births trauma infection or prenatal exposure to drugs 17 18 test date 102715 AUTISM SPECTRUM DISORDERS ASDs a group of developmental disorders characterized by deficits in communication social interaction and behaviors that meet diagnostic criteria in standardized testing with onset generally before age 3 PRADERWILLI SYNDROME condition in which partial deletion of chromosome 15 interferes with control of appetite muscle development and cognition EARLY INTERVENTION SERVICES federally mandated evaluation and therapy services for children in the age range of from birth to 3 years under the Individuals with Disabilities Act Nutrition Needs of Toddlers and Preschoolers with Chronic Conditions Higher energy needs cystic fibrosis renal disease ambulatory children with diplegia pediatric AIDS bronchopulmonary dysplasia BPD Lower energy needs Down syndrome spina bifida non ambulatory children with diplegia PraderWilli syndrome non ambulatory children with short stature CYSTIC FIBROSIS condition in which a genetically changed chromosome 7 interferes with all the exocrine functions in the body but particularly pulmonary complications causing chronic illness DIPLEGIA condition in which the part of the brain controlling movement of the legs is damaged interfering with muscle control and ambulation PEDIATRIC AIDS acquired immunodeficiency syndrome in which infection fighting abilities of the body are destroyed by a virus BRONCHOPULMONARY DYSPLASIA BPD condition in which the underdeveloped lungs in a preterm infant are damaged so that breathing requires extra effort RETT SYNDROME condition in which a genetic change on the X chromosome results in severe neurological delays causing children to be short thinappearing and unable to talk MENINGITIS viral or bacterial infection in the central nervous system that is likely to cause a range of longterm consequences in infancy such as intellectual disability blindness and hearing loss Feeding Problems test date 102715 ATTENTION DEFICIT HYPERACTIVITY DISORDER ADHD condition characterized by low impulse control and short attention span with and without a high level of overall activity NEUROMUSCULAR DISORDERS conditions of the nervous system characterized by difficulty with voluntary or involuntary control of muscle movement HYPOTONIA condition characterized by low muscle tone floppiness or muscle weakness HYPERTONIA condition characterized by high muscle tone stiffness or spas c y GASTRONOMY form of enteral nutrition support for delivering nutrition by tube directly into the stomach bypassing the mouth through a surgical procedure that creates an opening through the abdominal wall and stomach NutritionRelated Conditions MEDICAL NEGLECT failure of parent or caretaker to seek obtain and follow through with a complete diagnostic study or medical dental or mental health treatment for a health problem symptom or condition that if untreated could become severe enough to present a danger to the child SPASTIC OUADRIPLEGIA a form of cerebral palsy in which brain damage interferes with voluntary muscle control in both arms and legs ASTHMA condition in which the lungs are unable to exchange air due to lack of expansion of air sacs It can result in a chronic illness and sometimes unconsciousness and death if not treated WORK OF BREATHING a common term used to express extra respiratory effort in a variety of pulmonary conditions INTELLECTUAL DISABILITY substantially belowaverage intelligence and problems in adapting to the environment which emerge before age 18 years Food Allergies and Intolerance milk eggs wheat peanuts tree nuts soy crustacean shellfish ANAPHYLAXIS sudden onset of a reaction with mild to severe symptoms including a decrease in ability to breathe which may be severe enough to cause a coma test date 102715 Dietary Supplements and Herbal Remedies DRls for children with special conditions are only a staring point needs should be determined on a casebycase basis Chapter 12 Child and Preadolescent Nutrition MIDDLE CHILDHOOD 510 years school age PREADOLESCENCE the stage of development immediately preceding adolescence 9 11 for girls and 10 12 for boys Tracking Child and Preadolescent Health BMI for age BMI is still monitored based on percentiles instead of the actual calculated numbers Look at weight and height not just BMI Normal Growth and Development Body fat reaches the lowest point during early childhood and then usually rebounds around 6 years of age Boys have more lean tissue than girls Weight gain 7 lbsyear Height gain 25 inyear Appetite will increase especially during growth spurts Children are not usually put on diets the child is usually allowed to grow into their weight Physiological and Cognitive Development of SchoolAge Children 20 increased knowledge leads to increased ability more confident in their ability to do things preoperational seeobserve to concrete operations able to actually do things Parents older siblings and peers influence a child possibly eating behaviors Mother s concern with weight may influence child s especially daughter s eating habits 21 test date 102715 Imposing controls and restriction of forbidden foods may increase desire for and intake of the foods Energy and Nutrient Needs of SchoolAge Children Calories evaluate based on DRIs specific based on gender age height weight physical activity level Protein 095 gkg Fiber 48 years 25 g 913 boys 31 g 913 girls 26 g TOTAL FIBER sum of dietary fiber and functional fiber DIETARY FIBER complex carbohydrates and ignins naturally occurring an found mainly in the plant cell wall cannot be broken down by human digestive enzymes FUNCTIONAL FIBER nondigestible carbohydrates including plant animal or commercially produced sources that have beneficial effects in humans Iron 48 10 mg 913 8 mg Zinc 48 5 mg 913 8 mg Calcium 48 1000 mg 913 1300 mg 22 test date 102715 Calcium is especially important because bone formation occurs during puberty If the child is lactose intolerant they should consume calciumfortified products Do not completely eliminate dairy decrease only to point of tolerance Linoleic Acid 48 10 g 913 boys 12 g 913 girls 10 g AlphaLinolenic Acid 48 09 g 913 boys 19 g 913 girls 1 g Children sweat less and have more sodium and chloride in their sweat Cold water is the best fluid for children No energy drinks soft drinks should be limited Common Nutrition Problems iron deficiency dental carries Teach good brushing habits and limit sugary snacks Overweightobesity is more common in hispanic and nonhispanic black children adolescents Characteristics of OverweightObese Children taller advanced bone age early pubertylook older BONE AGE bone maturation correlates well with stage of pubertal development Early BMI rebound is a predictor for higher BMI in later childhood Parental obesity of a predictor of child obesity 23 test date 102715 Prevention of NutritionRelated Disorders in SchoolAge Children program that involves parent training dietary counselingnutrition education physical activityaddressing sedentary behaviors behavioral counseling Physical Activity Recommendations 60 minutes of physical activity per day are recommended Weight gain seems to be linked to inactivity rather than increased energy intake Obesity is related to screen time Resting energy expenditure decreases during screen time RESTING ENERGY EXPENDITURE the amount of energy needed by the body in a state of rest Girls are less active than boys Physical activity decreases with age Seasonal and climate differences are seen in children s activity levels Physical education in schools has decreased POURING RIGHTS contracts between schools and softdrink companies whereby the schools receive a percentage of the profits of softdrink sales in exchange for the school offering only that softdrink company s products on the school campus COMPETITIVE FOODS foods sold to children in food service areas during meal times that compete with the federal meal programs Public Food and Nutrition Programs Nutrition education in schools Provide nutritious meals to all children at school Financial assistance is provided by the government if certain requirements are met School Lunch fruits and vegetables are served daily half of grains must be whole grains only fat freelow fat milk limit calories based on child s age reduce saturatedtrans fatssodium School Breakfast Program test date 102715 kids who eat breakfast do better in school same kind of rules as lunch Summer feeding program COMMODITY PROGRAM a USDA program in which food products are sent to schools for use in the child nutrition program Commodities are usually acquired for farm price support and surplusremoval reasons Chapter 13 Child and Preadolescent Nutrition Conditions and Interventions Children Are Children First What Does that Mean Expectations that children will become more independent in making food choices assisting with meal preparation and participating at meal times apply to children with special health care needs Expectations are the same for all children with or without special needs Nutritional Requirements of Children with Special Health Care Needs Varies based on specific case As activity increases ADHD and ASD caloric need increases High protein is needed with high protein losses ex skin breakdown High fluid volume is needed with fluid loss from diarrheavomiting Protein recovery and cystic fibrosis 150 of normal protein needs Growth Assessment Growth charts are a good start for growth assessment but adjustments may need to be made Growth charts are available for some special conditions juvenile rheumatoid arthritis cystic fibrosis Rett syndrome spina bifida seizures type 1 and 2 diabetes 24 25 test date 102715 JUVENILE RHEUMATOID ARTHRITIS condition in which joints become enlarged and painful as a result of the dysfunction of the immune system generally occurs in children or teens Warning signs for growth problems plateau in weight pattern of gain then loss not regaining weight lost during an illness unexplainedunintentional weight gain SPINAL MUSCULAR ATROPHY condition in which muscle control declines over time as a result of nerve loss causing death in childhood SECONDARY CONDITION common consequence of a condition which may or may not be preventable over time SCOLIOSIS condition in which the vertebral bones in the back show a sideto side curve resulting in a shorter stature than expected if the back were straight NEUROMUSCULAR term pertaining to the central nervous system s control of muscle coordination and movement Nutrition Recommendations Supplements may be beneficial chewing problems liquid supplements diabetesketogenic diets avoid supplements with added carbohydrates KETOGENIC DIET highfat lowcarbohydrate meal plan in which ketones are made from metabolic pathways used in converting fat as a source of energy PKU avoid supplements with artificial sweeteners cystic fibrosis fat soluble vitamins galactosemia calcium supplements OSTEOPOROSIS condition in which low bone density or weak bone structure leads to an increased risk of bone fracture Eating and Feeding Problems in Children with Special Health Care Needs Cystic Fibrosis caloriesprotein increase 2 to 4 fold enzymes taken with meals to aid digestion 26 test date 102715 frequent mealssnacks Gastronomy feeding at night may be needed to boost energy intake Diabetes treatment timing and composition of mealssnacks exercise insulin injections for type 1 only INSULIN hormone usually produced in the pancreas to regulate movement glucose from the bloodstream into cells within organs and muscles Seizures Feedingeating during postictal state is not recommended because of the increased risk of choking POSTICTAL STATE time of altered consciousness after a seizure appears to be like a deep sleep Medications may impact growthappetite Cerebral Palsy slow growth difficulty feedingeating spastic quadriplegia causes even more nutrition problems PKU Nutrients are often provided in liquid form rather than solid form Avoid eggs meats dairy products nuts and soy beans ADD chaotic mealssnacks difficulty staying seated Medications may decrease appetite and growth but appetite returns to normal when the medication is not taken test date 102715 KETONES small twocarbon chemicals generated by breakdown of fatty acids for energy ATHETOSIS uncontrolled movements of the large muscle groups as a result of damage to the central nervous system NEUROBEHAVIORAL pertains to control of behavior by the nervous system PSYCHOSTIMULANT classification of medication that acts on the brain to improve mental or emotional behavior I am currently working on the Nutrient Needs Chart if you would like my copy of that as an additional study aid please let me know and I will be happy to get it to you You can contact me at regandoughertygmailcom rmdougherty1crimsonuaedu Let me know if you have any questions Good luck and happy studying 27
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