Running Head: NUTRITION ASSESSMENT

NURS104 Case Study Assignment: Nutritional Assessment on Infants

Danna Gonzalez
Humber College Institute of Technology and Advanced Learning

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Introduction

Nutrition is an important part of maintaining a healthy lifestyle because our body depends
on the foods that we eat. Optimal nutritional status describes an individual who acquires enough
nutrition that the body needs everyday; the status may change if the person becomes sick or
during pregnancy because the body will need more nutrients than usual (Jarvis, 2014, p. 198).
Undernutrition is when an individual receives less than the daily required nutrition, whereas an
individual who obtains more nutrition than what is required for the day is called overnutrition
(Jarvis, 2014, p. 198).
Even though people would like to eat healthy foods, maintaining the lifestyle may be
more difficult than others. For example, people who move to other countries may not have easy
access to the types of food they normally enjoy cooking and eating due to the differences in
culture (Potter et al, 2014, p. 7). In other cases, the income and social status affect the kinds of
foods people buy because they have to budget their payments (Potter et al, 2014, p. 7).
When assessing for a persons nutritional status, the primary step is a nutrition screening,
which consists of questions regarding recent changes in appetite and weight (Jarvis, 2014, p.
202). Gathering subjective data would mean that the client should report their nutritional intake:
the types of food he or she eats, as well how much and how often (Jarvis, 2014, p. 203). Helping
individuals adjust their nutritional intake will affect their health because the new diet will either
increase or decrease the amount of nutrition they usually take.
Case Study
In my case study, a 17-month-old toddler is brought in for an annual checkup by his
parents. His records indicate that he is 32lbs and that his immunizations are up-to-date. During
the physical assessment, the parents prepare a snack for their son, consisting of Dorito chips and

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juice substitute. While the toddler is left on the floor, he begins to cry after finishing his beef
jerky. His parents also stated that he does not like being left on the floor to crawl for too long,
otherwise he will start crying. After going through the protocol of measuring the toddlers vital
signs, the first priority assessment that I would make is to determine the nutritional intake using a
24-hour food recall. The second would be to measure the weight of the child and compare it to
last years data in order to determine the difference. Each of these priority assessments fall under
the collection of subjective and objective data.
Subjective Data and Nursing Interventions
There are a few ways of obtaining subjective data from the parents of the toddler, such as
the 24-hour recall, the food frequency questionnaire, the food diary, and direct observation
(Jarvis, 2014, p. 203). I would emphasize on doing a nutrition assessment with a 24-hour recall
because both the mother and father can better remember things compared to their son, especially
if they have to feed the him separately at some point during the day. In addition, their son is only
17 months old and is not able to communicate effectively, so the parents are a more reliable
source of information. I chose to focus on assessing the nutrition intake of the toddler because
the snacks I observed to be given to him by his parents were not appropriately and nutritious. For
example, the toddlers snacks included beef jerky, chips, and juice substitute; he does not even
have a full set of teeth to eat those kinds of snacks yet. Also, the juice substitute should be
replaced with milk because they provide more nutrients such as calcium, fat, and calories (Jarvis,
2014, p. 199). Therefore, I felt that it would be important to know what other kinds of foods the
parents give their son.
One of the nursing interventions that I would do is provide the parents with information
on Canadas Food Guide. This guide shows the types of foods that individuals should be eating

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everyday such as vegetables, fruits, protein, dairy, and grain products (Jarvis, 2014, p. 200). As a
health care provider, it is important to educate patients and clients about how to promote a
healthy lifestyle, especially when it comes to their diet (Potter et al, 2014, p. 4). If the family
recently came from another country, I would ask them what kinds of foods they like to prepare so
that I can make suggestions on dietary changes that accommodate their culture (Potter et al,
2014, p. 47).
Another suggestion that I would make to the parents is to consider administering
supplements to their child if they do not already do so. It is recommended that children who are
at least a year old should start receiving vitamin D supplements; it is crucial that infants and
toddlers receive as much nutrition as they can when they are at a young age in order to promote
optimal growth and development (Jarvis, 2014, p. 199). Vitamin D is an important component in
the regulation of calcium in bones, which would be of great help for toddlers learning to walk for
the first time (Jackson et al, 2006, p. 670).
Objective Data and Nursing Interventions
Anthropomorphic measurements consist of measuring the weight and weight change,
body mass index (BMI), waist-to-hip ratio, and height of an individual; they help indicate the
overall physical growth and development, as well as finding possible signs of risk for a disease
(Jarvis, 2014, p. 209). For the second priority assessment, I would compare the weight of the
child from the previous year to this years check up to determine if he was just born a large baby
or if he gained a lot of weight in the last year. According to the growth chart provided by the
World Health Organization, the toddler falls within the 97th centile under the weight-for-age
category; the average weight of a toddler at 17 months is about 27lbs (Dieticians of Canada,
2014). This means that the boy may be at high risk for obesity if the dietary lifestyle does not

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change (Dietz, 1994, p. 958). Because obesity and diabetes pose a as a health risk for the child
when he grows up, it would be important to learn of the familys health history as well. Knowing
the health history of the parents can give an insight as to what we could expect for their child,
such as the possibility for an increased risk in cardiovascular disease, diabetes, or obesity (Dietz,
1994, p. 955).
One of the first interventions I would do is to have the parents check in every month for
the next 3 months so that any different in the childs body weight can be calculated. I will inform
the parents of any weight changes and continue to encourage them to eat healthy. I would also
ask the parents about their socioeconomic status; many times, people are not able to buy good
quality and healthy foods because they are too expensive (Jarvis, 2014, p. 200). If the family
presents any financial problems that affect their diet, I would provide them with information on
which foods would be most important to eat so that they are able to prioritize their purchases.
Thirdly, I would conduct a question and answer session with the parents to get to know more
about their activities of daily living. Although this assessment is not directly associated with
nutritional intake, exercise is important to include when having to make dietary changes because
it further boosts metabolism and helps reduce the risks for diseases (Jarvis, 2014, p. 850).
Therefore in order to help maintain a healthy lifestyle, the parents and their child must
incorporate physical activities with their modified diet.
Conclusion
The nursing interventions that I planned for the parents are based on improving their
childs health through education on healthy foods and enhancing activities of daily living. To me,
improving diet is important to having a healthy lifestyle because the food consumed provides
nutrients that the body needs to metabolize. The family needed to be made aware of the kinds of

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foods they should be giving their child in order to reduce the possibility of passing on unhealthy
eating habits. In conclusion, the nutritional status of the toddler was highly dependent on what
food his parents gave him, as well as how active he was. The modification of these two factors
will enhance his health, and continuing to do so will further reduce his chances of obesity later in
the future.

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References

Dieticians of Canada. (2014). WHO growth charts for Canada [Data File]. Retrieved from
http://www.dietitians.ca/Downloadable-Content/Public/LFA-WFA_Birth24_BOYS_EN.aspx
Dietz, W.H. (1994). Critical periods in childhood for the development of obesity. The American
Journal of Clinical Nutrition, 59:955-9.
Jackson, R.D., LaCroix, A.Z., Gass, M., Wallace, R.B., Robbins, J., Lewis, C.E., Bassford, T.,
Beresford, S.A., Black, H.R., Blanchette, P., Bonds, D.E., Brunner, R.L., Brzyski,
R.G., Caan, B., Cauley, J.A., Chlebowski, R.T., Cummings, S.R., Granek, I., Hays,
J., Heiss, G., Hendrix, S.L., Howard, B.V., Hsia, J., Hubbell, F.A., Johnson, K.C.,
Judd, H., Kotchen J.M., Kuller, L.H., Langer, R.D., Lasser, N.L., Limacher, M.C.,
Ludlam, S., Manson. J.E., Margolis, K.L., McGowan, J., Ockene, J., OSullivan,
M.J., Phillips, L., Prentice, R.L., Sarto, G.E., Stefanick, M.L., Van Horn, L.,
Wactawski-Wende, J., Whitlock, E., Anderson, G.L., Assaf, A.R., Barad, D. (2006)
Calcium plus vitamin d supplementation and the risk of fractures. New England
Journal of Medicine, 354(7): 669-683.
Jarvis, Carolyn, Annette Browne, June MacDonald-Jenkins, Marian Luctkar-Flude. Physical
Examination and Health Assessment, Canadian Edition, 2nd Edition. Saunders
Canada, 2014. VitalBook file.
Potter, Patricia, Anne Perry, Janet Ross-Kerr, Marilynn Wood, Barbara Astle, Wendy Duggleby.
Canadian Fundamentals of Nursing, 5th Edition. Mosby Canada, 2014. VitalBook
file.

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