Child and Preadolescent Interventions Flashcards by Sydney Perry

Children with special health care needs have a wide range of nutritional requirements such as:

______ needs if small muscle size
______ is needed if protein losses or skin breakdown
______ is needed if frequent vomiting or diarrhea
______ for chronic constipation
______ due to DNI

Lower energy
High protein
Increased fluid
High fiber
Increase or decrease in micronutrients

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higher protein needs for recovery from ____ or ______

_____ requires 150% of DRI fro protein
_____ require decreased protein

burns or wounds

cystic fibrosis
PKU

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___________ are a good starting place for assessing growth
* Adjustments may need to be made for children with some conditions that affect the rate of growth
* _____ is not an appropriate tool for some conditions (i.e. cerebral palsy, paralysis)

CDC 2000 growth charts

BMI

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what are some warning signs for growth problems

plateau in weight

pattern of gain and then loss

failure to regain weight lost during an illness

unexplained or unintentional weight loss

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Intake may not be the only factor affecting growth for kids with chronic conditions
Other factors that affect growth assessment:
* Age of condition onset - ____ onset is more
likely to affect growth
* Secondary conditions may interfere with accurate measurements
- Example: ______ in children with cerebral palsy
* Activity level may be decreased

earlier

scoliosis

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Down syndrome results in short stature and low muscle tone and low weight due to _____________ (rather than nutritional intake)

Spina bifida may impact muscles only in the ____

Identified low fat stores means you need to _____ food intake

neuromuscular changes
lower body
increase

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Growth charts are available for some special conditions
* Some special growth charts are only based on the ______ form of the condition
* Many chronic conditions have such a wide range of severity that growth charts _____ be developed

most severe
cannot

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conditions that do not have growth charts

juvenile rheumatoid arthritis
cystic fibrosis
Rett syndrome
spina bifida
seizures
diabetes

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Children with special health needs often ____ from same general dietary recommendations as other children
* Assess intake to determine if energy & nutrient needs are being met
* Undernutrition may result in decreased effectiveness of _____ and _____ interventions

benefit

educational
medical

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_____ feeding is preferred method of feeding
* May require ______ in addition to or to partially replace meals or snacks

_____ feeding may be required for:
* Some cancers
* Severe cerebral palsy
* Cystic fibrosis
* Pediatric AIDS

oral
supplements

Gastrostomy

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Cystic fibrosis with pancreatic insufficiency=> requires__________ supplementation in ______ form

fat-soluble vitamin
water-soluble

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Galactosemia=> requires _____ supplementation

calcium

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Chewing problems=> need _____ supplements

liquid

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Children on ketogenic diets=> avoid supplements with _______

added CHO

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Children with PKU=> avoid supplements with _____

aspartame

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DRI for water is appropriate for most children:
* Age 4-8: ____ L/d
* Age 9-13: ____ L/d females & ____ L/d males

1.7

2.11
2.4

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conditions that increase fluid needs include:

Constipation from neuromuscular disorders
Crohn’s disease
Medication side effects
Uncontrollable drooling (from cerebral palsy)

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____% of children with developmental delays have feeding difficulties

70 %

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Examples of feeding problems include:
* ______ skills are lower than the child’s chronological age, requiring assistance & supervision
* Meals take an _____ amount of time
* The condition requires ______ in the timing of meals & snacks

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Self-feeding
excessive
adjustment

Dysfunction of the ______ glands that results in production of abnormally ____ secretions that obstruct glands & ducts
* ____system disorder
* Interferes with _____ function=> Dyspnea, frequent respiratory infections, & permanent lung damage
* Pancreatic insufficiency=> ________ due to lack of pancreatic enzymes

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exocrine
thick

multi

lung
malabsorption

nutritional issues for cystic fibrosis include

_______ nutritional needs due to work of breathing, frequent infections, and malabsorption
______ oral intake
Nutrient _______
______ rate of growth
______ risk for malnutrition

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Increased
decreased
deficiencies
slower
high

Energy needs vary widely: _____ times the DRI for age
* Frequent meals & snacks
* If pancreatic insufficiency=> ________ taken with all meals & snacks to aid in digestion
* MVI with minerals and _________ supplements
* _________ feeding at night may be needed to boost energy intake

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1.1-2.0
pancreatic enzymes
fat-soluble vitamin (in water-soluble form)
PEG/gastrostomy

Disorder in insulin regulation and glucose metabolism

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diabetes mellitus

problem and intervention for Type 1 diabetes mellitus

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virtually no insulin production

CHO counting
Education on meal planning

problem and intervention for Type 2 diabetes mellitus

high blood sugar only Education on meal planning weight management

Sudden, excessive, and disordered electrical disturbances in the brain

Epilepsy and seizures (same disorder)

Results of a seizure range from ______ to _______ * When seizures are well-controlled by medications, ______usually continues at a typical rate

mild blinking severe jerking growth

treatment of seizures and epilepsy

Eating during postictal state is not recommended due to the risk of choking * Medications—may impact appetite and nutritional status * Ketogenic diet—used as a last resort in children with intractable seizures when all other drug therapies fail

Broad range of disorders resulting from brain damage early in life with impaired muscle activity & coordination

cerebral palsy (CP)

_____________ is the form of CP that presents with the most nutritional problems

Spastic tetraplegia/quadriplegia

cerebral palsy side effects

primary - muscle stiffness secondary - contractures - scoliosis - GERD - constipation

nutrition concerns with cerebral palsy

- Difficulty with feeding & eating - Slow weight gain & growth - Changes in body composition which cause: * Fatigue at meal times, spilling food, long meal times, requiring assistance to eat * Dysphagia due to difficulty controlling muscles of neck & back for sitting up and muscles of jaw & tongue

energy needs of cerebral palsy

difficult to determine * Children with small or weak muscles have lower energy needs * Children with athetosis (uncontrolled movements of the large muscle groups) have increased energy expenditure

nutrition interventions for cerebral palsy

- Adjusting menus and timing of meals & snacks at home or school to meet nutritional needs and address fatigue - Adaptive feeding devices - Dysphagia assessment and interventions

PKU is an inborn error of metabolism * Absence or deficiency of ___________ – the enzyme needed to ______________ * It accumulates in the ____ and is toxic to _____ – without treatment it causes _____

phenylalanine hydroxylase metabolize phenylalanine to tyrosine blood brain tissue severe intelectual disability

treatment of PKU

Lifelong restriction of phenylalanine * 80-90% of protein needs is met by a phenylalanine-free formula Dietary treatment includes complete avoidance of: - meat, fish, eggs, dairy products, nuts, legumes, & soybeans

Most common neurobehavioral condition in children is ______ what percent ?

ADHD 11%

medication for ADHD that can affect Nutrition ? how so?

Ritalin and Adderall - may decrease appetite

nutrition intervention for ADHD

Time meals considering medication action peaks * e.g. Providing a large, healthy evening snack when medication effects are lower *No proven evidence of nutrition as a cause or as a treatment but families still often choose to use herbal medicines & nutrition supplements

Treatment of pediatric HIV includes ______, which may lead to ______.

antiretroviral therapy anorexia (loss of appetite)

pediatric HIV nutrition interventions?

–Educating family on DNI and feeding schedules –Education to prevent food-borne illness –Assessing for financial difficulties and referral to services (i.e. food bank) If inadequate intake, use of –Oral nutrition supplements –Gastrostomy tube feeding

childhood celiac disease is a _____ condition which is _____ in prevalence. It is also ______ in children, maybe bc it ______.

chronic increasing under diagnosed presents differently in children

celiac disease may interfere with _____ and ____. most effective treatment is ________.

learning and growth avoiding gluten for life

department of education public school regulations includes * _____ accommodations * Requires that school provide a _______ to accommodate for special health care needs

504 written plan

A law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children * Nutritional services may be written into a child’s _____________

Individuals with Disabilities Education Act (IDEA) Individualized Education Program (IEP)

Child and Preadolescent Interventions Flashcards

(45 cards)