Altered Nutrition and Metabolism Quiz
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Questions and Answers

What can cause vomiting and/or aspiration during enteral feedings?

  • Tube incorrectly placed (correct)
  • Medications affecting digestion
  • Low-fiber formula
  • Rapid feeding

    • Which of the following solutions is effective in managing diarrhea during enteral feedings?

  • Increasing feeding volume
  • Discontinuing tube feeding
  • Using a high-fiber formula
  • Evaluating current medications (correct)

    • Which of the following is NOT a cause of constipation in patients receiving enteral feedings?

  • Medications
  • Contaminated formula (correct)
  • Fecal impaction
  • Inadequate fluids

    • What should be done if a patient exhibits increased residual volume during feeding?

    <p>Check the tube position and delay feeding</p> Signup and view all the answers

    When managing diarrhea in enteral feeding, which adjustment is recommended?

    <p>Use continuous drip feeding</p> Signup and view all the answers

    What action should be taken concerning enteral feeding formula to prevent complications?

    <p>Discard formula after 24 hours</p> Signup and view all the answers

    What anatomical structure is primarily affected in hypertrophic pyloric stenosis?

    <p>Pyloric sphincter</p> Signup and view all the answers

    Which symptom is most characteristic of hypertrophic pyloric stenosis?

    <p>Projectile vomiting</p> Signup and view all the answers

    In which week of embryological development does cleft lip typically occur due to the failure of the medial nasal and maxillary processes to merge?

    <p>Fifth week</p> Signup and view all the answers

    How should a mother position her infant with a cleft palate while breastfeeding to facilitate feeding?

    <p>With the head elevated and cleft uppermost</p> Signup and view all the answers

    What is a common treatment for dehydration in infants with hypertrophic pyloric stenosis?

    <p>Intravenous fluids</p> Signup and view all the answers

    What is the resting energy expenditure (REE) for a child aged 1 to 3 years?

    <p>50 to 57 Kcal/kg/d</p> Signup and view all the answers

    How do stress factors affect Total Energy Expenditure (TEE) in pediatric patients?

    <p>They can multiply the REE by various coefficients depending on the condition.</p> Signup and view all the answers

    Which age group has the lowest recommended dietary allowance (RDA) for calories per kilogram per day?

    <p>15 to 18 years</p> Signup and view all the answers

    What is the recommended protein intake per kilogram per day for children aged 7 to 10 years?

    <p>1.0 to 3 g/kg/d</p> Signup and view all the answers

    In the context of preventing occlusion of enteral feeding tubes, what is a recommended action?

    <p>Establish a regular flushing schedule after each feeding.</p> Signup and view all the answers

    What is a common physical cause that can lead to failure to thrive in children?

    <p>Renal disease</p> Signup and view all the answers

    Which of the following is NOT a psychosocial factor contributing to failure to thrive?

    <p>Anemia</p> Signup and view all the answers

    What is the primary measure used to diagnose failure to thrive?

    <p>Weight percentile</p> Signup and view all the answers

    Which intervention can help manage dehydration in a child experiencing high protein formula intake?

    <p>Consult a dietitian</p> Signup and view all the answers

    Which factor would not typically require consideration when evaluating a child's dietary intake history for failure to thrive?

    <p>Family history of diseases</p> Signup and view all the answers

    What is a common misconception about the diets of children who exhibit signs of failure to thrive?

    <p>They are often on extreme or fad diets.</p> Signup and view all the answers

    During which observation should family interactions be assessed for diagnosing failure to thrive?

    <p>Throughout all feeding times</p> Signup and view all the answers

    What dietary intervention might help with a child who has demonstrated inadequate supply of breast milk?

    <p>Consultation with a lactation expert</p> Signup and view all the answers

    At what age does a child typically begin using short sentences and pronouns while communicating?

    <p>2-3 years</p> Signup and view all the answers

    By the age of 12 months, a child's growth typically includes what milestone regarding their head and chest circumference?

    <p>Head and chest circumference are equal.</p> Signup and view all the answers

    What describes the mobility skills of a child who is 1-2 years old?

    <p>They can take first steps, walk, and go up and down stairs.</p> Signup and view all the answers

    What dietary change occurs when a child reaches 1-2 years of age?

    <p>Transition to whole cow's milk and a wider range of foods.</p> Signup and view all the answers

    At what age do most children typically become potty-trained?

    <p>Between 18-24 months</p> Signup and view all the answers

    What is the recommended maximum caloric content per ounce of formula for young infants?

    <p>24 Kcal</p> Signup and view all the answers

    At what rate should infants gain weight during the first month of life?

    <p>4-7 ounces per week</p> Signup and view all the answers

    Which reflex is likely to fade by 4 months of age?

    <p>Moro reflex</p> Signup and view all the answers

    What is the expected urine output for an infant during the first month?

    <p>8-10 times/day</p> Signup and view all the answers

    What is the minimum recommended feeding frequency for bottle-fed infants in the first month?

    <p>Every 3-4 hours</p> Signup and view all the answers

    Which aspect of feeding is emphasized for toddlers in managing malnutrition?

    <p>High-caloric milk drink (PediaSure)</p> Signup and view all the answers

    What should be avoided in the feeding environment to support successful nutrition for infants?

    <p>Frequent meal timings</p> Signup and view all the answers

    What is a notable change in an infant's mobility during the 2-4 month milestone?

    <p>Ability to roll from stomach to back</p> Signup and view all the answers

    What is the expected length growth for infants during the first month?

    <p>1.5 cm</p> Signup and view all the answers

    At what age is an infant expected to begin following objects 180° with their eyes?

    <p>2-3 months</p> Signup and view all the answers

    What is the average total amount of sleep a child typically gets between 4 to 6 months of age?

    <p>15 hours</p> Signup and view all the answers

    Which developmental milestone is expected to be achieved by a child by 8 months of age?

    <p>Crawling or creeping</p> Signup and view all the answers

    At what age is a child likely to begin feeding on solid foods multiple times a day?

    <p>6-8 months</p> Signup and view all the answers

    How often should a child approximately urinate by 6-8 months of age?

    <p>5-6 times daily</p> Signup and view all the answers

    Which statement best describes a 4-6 month old's ability to communicate?

    <p>They vocalize responses and imitate tones.</p> Signup and view all the answers

    What significant change occurs regarding a child's ability to grasp objects by 8-10 months?

    <p>Mastery of using pincer grasp for picking up small objects.</p> Signup and view all the answers

    What is the typical growth pattern for a child between 6 to 8 months?

    <p>Gains about 3-5 oz per week and 1 cm in length per month.</p> Signup and view all the answers

    At what stage is a child expected to start teething and solid foods such as meat introduced?

    <p>8-10 months</p> Signup and view all the answers

    What new sensory skill is typically seen in children around 6-8 months of age?

    <p>Turning head to sounds and following objects.</p> Signup and view all the answers

    How many times per day should a child expel stools by 8-10 months if their diet includes solid foods?

    <p>1-2 times daily</p> Signup and view all the answers

    Study Notes

    Hypertrophic Pyloric Stenosis (PS)

    • PS results from hypertrophy and hyperplasia of the pylorus muscle, leading to obstruction between the stomach and small intestine.
    • More prevalent in boys with genetic factors possibly influencing occurrence.
    • Diagnosis typically involves ultrasound imaging.
    • Symptoms appear generally after 3 weeks, including:
      • Projectile vomiting, often non-bilious, occurring shortly after feeding.
      • Notable weight loss and signs of dehydration despite eagerness to eat.
      • Palpable abdominal mass located in upper right abdomen.
      • Visible peristaltic waves.
    • Treatment includes:
      • Intravenous fluids for hydration and electrolyte restoration.
      • Surgical intervention (pyloromyotomy) to alleviate muscle restriction.

    Orofacial Clefts

    • Clefts encompass:
      • Cleft Lip (CL): Failure of fusion between nasal and maxillary processes during the fifth week; usually repaired surgically by 10 weeks.
      • Cleft Palate (CP): Occurs when palatal shelves of the maxilla do not fuse, typically needing surgery around 4 months; ranges in severity from bifid uvula to complete cleft involving hard and soft palate.

    Feeding Strategies for Infants with Cleft Lip or Palate

    • Infants may require enteral feedings; many can be breastfed using specific positioning techniques.
    • Those with isolated cleft palates face challenges in creating suction needed for breastfeeding.
    • Techniques include maternal breast sealing over the cleft or using fingers to assist.
    • Pumped breast milk can provide nutrition to infants with bilateral clefts, promoting benefits from maternal antibodies.
    • Goals focus on adequate weight gain, minimizing aspiration risks, and preventing ear infections.

    Nutritional Needs for Enteral Feedings

    • Caloric measures based on age, size, and stress, with breast milk as optimal nutrition.
    • Standard formula contains 24 to 30 calories per ounce, tailored according to health conditions like heart failure.

    Total Energy Expenditure (TEE)

    • TEE is calculated by adding resting energy expenditure (REE) with stress factors related to activities and health conditions.
    • Varied stress factors include maintenance, activity level, presence of fever, burns, trauma, and growth requirements.

    Enteral Feeding Complications

    • Vomiting and Aspiration: Caused by incorrect tube placement, delayed gastric emptying, or contaminated formula; solutions include checking tube placement and elevating the bed.
    • Diarrhea: Linked to rapid feeding or medications; managed by adjusting feeding rates and changing formulas.
    • Constipation: Results from inadequate fluid intake or specific medications; strategies include increasing fluids and adjusting formula composition.
    • Dehydration: May stem from diarrhea or poor intake; treated by increasing fluid consumption and addressing dietary formula needs.

    Failure to Thrive (FTT)

    • Defined by inadequate growth, typically under the 5th percentile for weight; causes may be physical, psychosocial, or idiopathic.
    • Socioeconomic factors and insufficient nutritional awareness can lead to FTT.
    • Management involves evaluating dietary intake, family dynamics, and addressing potential health conditions.

    Normal Growth and Development Milestones

    • First Month:
      • Sleep approximately 16 hours daily.
      • Weight loss of 5-7% before gaining 4-7 ounces weekly.
      • Reflex activities present; brief communication through crying.
    • 2-4 Months:
      • Increased alertness with growth of 5-7 ounces weekly.
      • Development of gross motor skills such as lifting the head.
    • 4-6 Months:
      • Doubling of body weight by 5-6 months with mobility development including rolling over.
    • 6-12 Months:
      • Slower growth with initiation of solid foods; increased babbling and social interactions.
    • 1-3 Years:
      • Independent mobility with first walking steps; vocabulary begins expanding toward short sentences.
    • 3-6 Years:
      • Steady growth with development of fine motor skills; complex vocabulary usage.
    • 6-12 Years:
      • Routine assessments to identify developmental delays; emotional and social influences become prominent during early adolescence.### Developmental Concerns in Adolescents
    • Delayed maturation and short stature are common developmental issues, particularly in females.
    • Spinal curvature and poor dental health (e.g., caries, malocclusion) are notable concerns.
    • Chronic illnesses like diabetes may impact adolescent development.
    • Lack of physical activity and poor nutrition, including conditions like anorexia, contribute to developmental challenges.

    Middle Adolescence (15-17 Years)

    • Body changes stabilize, shifting focus to self-image and peer perception.
    • Girls often emphasize weight concerns, while boys may focus on muscle development.
    • Sexual curiosity leads to experimentation, alongside an identification with peer groups and related behaviors.
    • Developmental issues include persistent gynecomastia in males and acne in all genders.
    • High-risk behaviors like unprotected sex and experimentation with drugs and alcohol can arise.
    • Struggles with authority, academic performance, and impulse control are prevalent.

    Late Adolescence (18-21 Years)

    • This period marks the transition toward adult responsibilities, including work and education.
    • Young adults may still grapple with unresolved issues from middle adolescence, affecting personal growth.
    • Concerns include low self-esteem, lack of intimate relationships, and continued gang associations.
    • High-risk sexual behaviors persist, often resulting in multiple partners and unprotected sex.
    • Academic difficulties and reliance on peer groups or parents can hinder maturity.

    Types of Malnutrition

    Protein Malnutrition (Kwashiorkor)

    • Characterized by inadequate protein intake while fat and carbohydrate consumption may be sufficient.
    • Rapid onset, with observable symptoms like hypoalbuminemia, edema, and delayed wound healing.
    • Common causes include chronic illness, infection, or traumatic injuries.

    Protein-Calorie Malnutrition (Marasmus)

    • Involves deficits in both protein and calorie intake; often visibly apparent.
    • Children present as thin due to skeletal muscle loss; however, immune function tends to remain intact.
    • Symptoms include decreased basal metabolism, hypothermia, and bradycardia.

    Mixed Protein-Calorie Malnutrition

    • Combination type seen frequently in hospitalized patients, manifests through acute onset of low visceral protein and weight loss.

    Signs of Neglect in Children

    • Indicators of neglect include unkempt appearance and inadequate clothing, along with poor hygiene.
    • Children may display lethargy during the day and experience numerous medical or dental issues.
    • Lack of supervision can lead to underweight conditions, missed medical appointments, and insufficient immunizations.
    • Assessment of neglect might require home visits, especially in vulnerable populations, with reporting to child protective services necessary for further evaluation.

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    Description

    Test your knowledge on hypertrophic pyloric stenosis, a condition characterized by the obstruction of the pyloric sphincter. This quiz covers its causes, diagnosis, and associated risks, particularly in boys. Understand the implications of electrolyte imbalances and the genetic factors related to this condition.

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