Vous êtes sur la page 1sur 21

Nutrition and


Afroz lakhani RN,BScN

Objectives for Unit 1

 Conduct nutritional assessment

 Identify and manage nutritional
problems affecting child
 Provide health education to assist
moms to improve the quality of
the nutrition of their children.
(group activity)
Goals of Nutrition
 To collect information necessary to
document adequacy of nutritional
status or identify deficits
 To develop a nutritional care plan
that is realistic and within family
 To establish an appropriate plan
for monitoring and/or
Nutritional Assessment
 Important part of
child’s physical
 It includes:
1. Dietary Intake
2. Clinical examination
3. Evaluation of
 Dietary evaluation is an
important. component of
the child’s assessment.
 Knowledge of child’s
dietary intake is an
essential component of a
nutritional assessment.
 Dietary intake requires
specific questions thus
excellent dietary history
Dietary History
 Most common and easiest method is 24
hr recall.
 Gives you qualitative information.
 Important that it is accurate.
 Create food models for portion size.
 A 3-day record consisting of 2 weekdays
and 1 weekend day.
 Helpful tool when verifying a dietary
history taken by you at initial
Dietary History

 Family usual mealtimes

 How money is spent
 Child’s eating habits
 Dental history
 Activity level
 Recent change in weight
 Any culture practices
Additional questions for
 Birth weight….double,
 Breast-fed or formula/
cow milk
 Any extra fluids like
water/ juice
 Bottle timings??
 Cereal/solid food history
 Any additional
 Stool history
 How often is the feeding
Clinical Examination

 Lets do clinical assessment of Nutritional Status

(Nursing Care of Infants and Children-WONG)
pg 161 Table 6-1
Evaluation of nutritional
 After collecting data, evaluate the findings
about the child.
 From the data:
1. Malnourishment
2. At risk of malnourishment
3. Well nourished
 Analyze food diary for complete nutrition.
 Compare findings from clinical examination
and anthropometry with data obtained from
the dietary intake. E.g. signs of anemia and
poor diet of iron suggests lab evaluation line
hemoglobin, hematocrit and transferrin.
Common Nutrition
Problems & Concerns
 Growth
 Diet/nutrient intake
 Feeding problems
 Medication/nutrient
 Supplements/alternative
 Special diets, i.e. PKU
 Dental and nutrition
 Bowel management
Steps to Evaluating Pediatric
Nutrition Problems

 Screening
 Assessment
 Intervention
 Monitor
 Reassessment
Nutritional Problems and
 Malnourishment can lead to death
 Difficulties with breastfeeding: check
the technique. If deformity (cleft-lip
and palate) can teach mother to
express her milk and give baby by cup
or milk.
 Mom’s issues: death-another woman
who can breast feed. HIV positive
moms should continue if formula feed
is simply impossible.
 Improve food calorie for small children by adding little
oil, margarine or peanut paste.
 Giving small frequent meals.
 Give mashed up food etc if child is not interested.
 Germinated porridge (bacteria less likely to grow thus
reducing episode of diarrhea) than plain one.
 Low growth and development: Iodine intake e.g salt
 Anemia: Iron rich food, long-term developmental
problems, and poor school performance
 A lack of zinc can cause an increased risk of infection
and slow growth
1. Marasmus:
 Signs of very low weight.
The child will be below 60%
of normal and the third
centile on the growth chart.
 Extreme wasting, very thin,
arms and legs are like
 Looks old, worried and
 Pot belly
 Irritability
 Hunger
 2.
: edema, moon
face, poor
 Correct micronutrient
deficiencies. (give multivitamin
supplement, folic acid 1 mg per
day. Dose of vitamin A and Iron
once start to gain weight.
 Small frequent feeds, low in
protein and sodium, high in
potassium and magnesium,
 N/G feed if child is reluctant,
 Correct electrolyte imbalance.
 Carpenito, J.L. (2002). Nursing diagnosis: Application to clinical
practice (9th edition) Philadelphia: Lippincott.

 Huether & McCane. (2000). Understanding Pathophysiology (2nd

edition) Mosby

 Huband, Hamilton Brown Barber. (2001). Nursing and Midwifery (1st

Edition) Macmillan
 Illustrated manual of Nursing Practice (2002). 3rd edition.

 Kozier & Erb. (2008). Fundamentals of Nursing (8th edition) New

Jersy: Pearson.

 King, King, Martodipoero. (1978). Primary Child Care. Oxford Medical


 Porth.(2005). Pathophysiology (7th edition) Lippincott

Ross and Wilson. (2006).
 Anatomy and physiology (10th edition) Churchill Livingstone