ped nutrition

carbonhydrate

essential nutrient; fiber, vitamin B C E, trace element, provide source of nenergy

complex cabronhydrate

-take longer to brekdown

-need more time to digest

-found in flour,grain, starchy veggie

-conserve energy,control insulin level

simple carbonhydrtae

-taste sweet

-easier to digest immediately incomplete digest

-rapidly increase blood glucose lvel

fat

• 2nd source of energy

• permit fat soluble vitamin A D EK absoprtion

• add falvor

• body fat is aprotective layer and thermoregulation

• monosaturated and polyunsatureed fat can help lower LDL and raise HDL

protein

-build tissue and promote fluid balance

0source of vitamin and mineral

-promote immune system

water

-transport nuteient to cell and waste product

-regulate body temperature

-need are influence by activity and ambient

vitamin and mineral

-aid metabolic process regulation take place in cell and tissue when energy released and CO absorbed by blood to betrasnported

-add to process formula and cereal

-except VD, not require supplemental vitamin

canadien food guide

-half veggie and fruit

-1/4 protein

-whole grain

-cut sugar

toddler to preschooler nutrition

-period of slow growth, less calorie protein fluid need

-food experience lasting effect on how food are viewed

-avoid distraction

-optimize setting and good habit

toddler to prechooler nutrition requirement

-milk remain source of VD ,provide supplement if needed

-lean meat, fish, nut,low sugar cereal provide iron

toddler to reschollder solid food

-use spoon progress to fork and knife

-introduce slowly

-small portion in small piece 3 meal 2 snack

-variety of texture ,color and temp

-sugar and sweetner should be avoided for empty calorie

toodler-prescholler nutritional challenger

-food jag;same food for days and reject

-fussy eating due to food tempeature ,odour

-prefer juice

-avoid negative comment

-ritualistic,same utensil, regular meal time to lower stress

-still chocking risk

toodler and preschooler physio anorexia

-lack of appetite r/t physio need

-limit snack,provide small nutritious snack

-mealtime not a time to discipline or foce to eat after family left

-focus on weekly than daily intake

schooler nutrtional requirement

-slow but steady frowth with increase appetite to match energy need

-fewer food idosyncrasies unless established

-eat quickly die to preoccupation with activity

-adolescent growth spurt +11yr, result in increase protein and calorie need

-late eleenatary-body image concern lead to eating disorder

schooler nutrtionsl challenge

-more away from home, lack of family supervision

-not eat bag lunch trade food

-eat inscheldure oftern interuupted by extra activity and sport

-encourage health snack but not high cslorie

-skip breakfast toward fast junk food

adolescent nutrtionsl requirement

-wellness, treated with confidentiality

-accelerate grow in ht, wt, muscle mass,increase proetin ,calorie,zinc ,calicum and bone to support bone nd muscle growth, greated bllod volume

-interested in nutrtion and food effect

=body image ,weight ,secual develp,ent,bear nutrtion intake (vegan,bulking) from social media

adolescent nutrional challenge

-eat insocial event ,less parental supervision

-girl more risk for nutrion deficency ,boy higher intake

-fast junk food predominate

adolesecent guide

-rrecognize their need is independent make owne chocie,incolve in palnning

-vegan is expected choice,low fat alternative can prevent future

-body image influence by social media

-weight loss and increas muslxe lead to restrictive eating,induce bomintg,use of drug,igonor development

=refer to adolescent couseling

culture influence

-infleucne by culture and religious practice and belief

-food prohibition

judaism-no pork, hindu-no beef

anthropometric data

-height and head circumference -past and chronic nutrional problem

-weight and mid arm circumbasance and BMI determine nutrion stauts

growth chart should influece

-gestation age

-birth weight

-chronic illness

-parent wieght and height

-child nutrition profile

clinical evaluarion

-hx and physical exma to area reveal deficncy -shinny bone,teeth-bumia

biochemical test _vitamin andiron,elecrolyte imbalnce

diet hisorey

24 hour eecall-not accurate, list all food consumed

-food diary=done over longer time 3-7 days,inflcude time and presence of people, influence eating behavirous,environment distracr

obesity challenge

30% is overweightbecause higher than necessary caloric intake and alck of physcial acitvity,income gene,education

obesity mangement

-not as reward

-establish schedure, food diary

-offer health food limit fast food

-model healthy eating and exercise

-encoruage play activity

-treatment :decrease quality,improve quality,

IBD def

in adolecen in young adult

faukty regulation of immune response of intestinal mucosa

system inflamation

risk of remission,excaerbation

Bf can lower risk

crohn eiology

affect any part of GI tract from moth to anus

UC etiology

only affect colon and rectum large intestine

ss of uc

uc: rectal bleeding,uregent bloody diarrhea,c,less pain,moderate anorexia,weight loss,growth delay,mild rash

ss of crohn

watery diahea,abd pain,severve weight loss,anorexia,growth delay,anal lesion,fistula,

IBD med

1st induced: less remesion and cute ss

aminocalycylate-pentasa

2 not for long time use-corico-growth supression

3,abx falgyl

4.immunosupressant;lower intestinal. side effect:peripheral neuropathy,metalic taste

5.chemo -methotrexate'

6.antidiarrhea

diet IBD

-TPN:lipid,vitamine

-enteral feeding

-low fiber,low residue,low fat,high proetein,milk free—grow failure as cmplication

IBD goal of tx

-control inflammation and pain,treat infection

-pbatain long term remission

-promoto normal growth

-promote optimal nutrtion

IBD community nursing interventiin

-assess nutrtion status

-keep foot log,indentify trigger

-assist with meal plan,include small freuqent meal,no high fiver food

-assit coping if increase stress

-avoid large meal,fluid between meal

IBD hospitalized pt

-tpn

-I&O

-blood glucose,electoryte

-stool

-pain

monitor developmetal milestone

-monitor weight

celiac etiology

-gluten enteropathy

-chronic antoimmune gentic

-enbale to digest gluten

-lifelong

celiac charasteristic

-steatorrhea

-malnutrition

-abd distention

-vitamin deficency

glute can be found in

wheat

barley

rye

oat

ss of celiac

Muscle wastint

abd distention/anemia(folate)/anorexia

lactose intolerance

nausea vomiting

ostro change-frowht failure

unexpected slow growth

rash

irritability

stearhea

hypoproteinmia

edema

diahea

celica diagnosis test

antiobody and immunglobulin test

elminate glute from diet seen in weeks

celiac disease mangement

-lifelong gluten free

-read label

-finacial burden

-vitamin supplement

-infant tood;er easeir to manage

-diet support,professional involve

celiac nursing assessment

motior growth chart

motiro type of food and adequate caloric intake

physical ss:diarrhea formed stoll

food toavoid incelia

flour,beer,ramen,bread,soy sauce,pasta

DM2 etiology

insulin resisstance with insulin deficency

increase overweight and obese child

DM2 risk factor

-gestation dm

-oveerweight obesity

lack of physical activity

-family hx

-race ethnicty

-popverty

ss of DM2

-glycouria

-absend or mild polydipasia,polyuria

-little weight loss

hyperglycemia

-acanthosis nigrican

-overweight

-fatigue

-yeast infection;thrush

-blured vision

DM2 therapeutic meangment goal

-weight loss

-diet mangement-reguided diet

-60-90 physical exercise

-less than 60min screen time

-blood glucose motiro

-more bF

-might need med

FTT def

sign of inadeuqte growth result from inability to obtain or use calorie reuqired for growth

BMI for age is a single diagnosis criteria

organic FTT cause

chrmosomal abnormality

heart and lung disease

CNS damage

premature

toxin exposure

inorganic FTT cause

no medical cause

r/t psychosocial environement;neglect,poor patenting skill,patental mental health

-poverty,poor social support,poor mother child bonding,maternal depression,poor food and feeding difficulty

FTT major ss

weight below 5%

sudden growht curve deceleration

delay reaching developmetnal milestone

decrease muscle mass

other ss of FTT

muscle hypotonia

abd distention

genrelized weakness-muscle wasting

cachexia

behaviroual ss of FTT

avoid eye contact

avoid physcial tough

intense watchfulness

sleep disturbance

FTT treatment

-rule out cause, if not is nonorganic cause

-nutrional support

-nurture

-psychotherapy

-ideal outpatient setting

-family therapy

-vitamin supplementation

FTT nursing assessment

-assess contributing factor

-psychosocial hisotry

-nutrional assessment

-parent interaction:role modeling,encourge ,increase confidence

-support physcial growth

eating diasorder common

in female, increase occur in male

concurrewnt with mental illness

anorexia charcteristic

=reduse to maintain body weight

-restrict caloric intake

-distorted body imahe

-amenorrhea lack of fat

-great length to conceal disorder

sucidial

anorexia ss

weight 155 below

-disotorted body image

-3 missed mesturation

-laugo

-dry flaky skin

-dull brittle hair

-fatigue

-muscle wasting

male become stron and muscular

bulmia definition

recurent binge eating epidode

-self induce vomiting

-lack of control over eating

-excessive laxative,dirutic ,emetic intake prevent weight gain

-peristant body image concern

bulmia ss

-minimum 2 binge eating per week

-last 3 month

-irrational body shape and weight concern

-tooth erosion-vomiting induce

-excessive exercise

-maintain normal wweight

eating disorder hosptialize reaons

treated in outpt clinic usually

-severe dehydration and electorlye imbalance

-cardciac instability HR<40

-sucidal ideation

-putpatient treatment failure

therapeutic managemnt eating disorder aim

physiological stability-postural hypotension

body weight stability

prevent electorlyte imbalnce

psychological tx for eating disorder aim at

restructe cogitve perception

reduce opportunity to enegage ritualism

nutrional consultation for eating disorder aim at

-reveal cureent diet intake,eating pattern,belief about food and weight,use supple,ent

discuss psychological problem

nursing assessment for eating disorder

ohyscial exam

health hisotry

nutrtion assessment

asess self perception

intake and output

vs

weight

cardaic stauts

refeeding syndrom monitor

fluid volume excess

serum deficiency in electorlyte and vitamin