Nutrition Interventions for Children with Special Health Care Needs

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Chapter 11 - Community Monitoring of the Patient on Home Parenteral Nutrition and regularly re-assess nutrient needs. Guidelines for the technical aspects of PN, including complications of PN, are provided in Appendix O. The remainder of this section presents the basic guidelines for monitoring a child on home PN Regular assessment and monitoring by a team of health care professionals, physician, pharmacist, and registered dietitian (RD), with PN experience is essential. Coordination of care between the ordering physician, and home care company is vital. 130 Nutrition Interventions for Children With Special Health Care Needs
Table 11-1: Community Monitoring of the Pediatric Patient on Home Parenteral Nutrition Assessment Intervention Evaluation/Outcome Anthropometric after hospital discharge * Measure and plot on appropriate growth chart Steady, stable weight gain to maintain normal growth curve. If weight loss or no weight gain, increase energy provided by PN solution. Consistent linear growth. Consistent increase in OFC in usual growth channel. If rate of weight gain exceeds recommended guideline on 2 consecutive visits, decrease energy provided by PN solution.6 • Weight for age (weekly for infants, 2 times per month for older children) • Length for age (0-3 years) (every 2 weeks for infants 10th percentile Use information in assessing child’s energy and protein needs Measure (2 years and older) every 1-3 months, depending on clinical status: • Triceps skinfold • Mid-upper arm circumference • Subscapular skinfold Section 2 - Problem-Based Nutrition Interventions Calculate: • Arm muscle area • Arm fat area Biochemical Frequency of monitoring biochemical indicators depends on the child’s clinical condition and the protocol established by the institution. Once the medical condition is stable, labs are generally done every 1-3 months or when PN solution is adjusted: • Electrolytes • Blood glucose • Calcium, phosphorus, magnesium • Creatinine, BUN • CBC, platelets • Prealbumin, albumin Nutrition Interventions for Children With Special Health Care Needs 131 Biochemical indicators in the normal range Work with PN team to monitor biochemical indicators and assess need to adjust PN solution. (See next page for continuation)
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Nutrition Interventions for Childre
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Kay Kopp, OTR/L Occupational Therap
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Appendices Appendix A Sample Screen
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ii Nutrition Interventions for Chil
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Population “Children with special
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vi Nutrition Interventions for Chil
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Chapter 1 - Nutrition Screening and
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Chapter 2 - Anthropometricss needs,
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Chapter 2 - Anthropometricss Statur
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Chapter 2 - Anthropometricss Techni
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Chapter 2 - Anthropometricss paraly
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Chapter 2 - Anthropometricss time a
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Chapter 2 - Anthropometricss measur
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Chapter 2 - Anthropometricss Mild m
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Chapter 2 - Anthropometricss 9. Re-
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Chapter 2 - Anthropometricss 5. Per
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Chapter 2 - Anthropometrics Table 2
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Chapter 2 - Anthropometricss Refere
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Chapter 2 - Anthropometricss 26. Kr
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Chapter 3 - Physical Activity for C
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Chapter 4 - Breastfeeding recommend
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Chapter 4 - Breastfeeding Table 4-1
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Chapter 4 - Breastfeeding Assessmen
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Chapter 4 - Breastfeeding 58 Nutrit
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Chapter 5 - Medication-Nutrient Int
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Chapter 6 - Nutrition Interventions
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Chapter 16 - Nutrition Intervention
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Chapter 22 - Ketogenic Diet for Sei
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Appendix A Please list any other nu
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Appendix A Baby formula What kind o
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Appendix B Manufacturer Description
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Appendix C 282 Nutrition Interventi
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Appendix D 284 Nutrition Interventi
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Appendix E 292 Nutrition Interventi
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Appendix E Table 3: Parent-Specific
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Appendix F Percentiles of Upper Arm
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Appendix F 302 Nutrition Interventi
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Appendix G 304 Nutrition Interventi
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Appendix H 312 Nutrition Interventi
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Appendix I 320 Nutrition Interventi
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Appendix J 328 Nutrition Interventi
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Appendix K 336 Nutrition Interventi
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Appendix K 338 Nutrition Interventi
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Appendix L 340 Nutrition Interventi
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Appendix M 342 Nutrition Interventi
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Appendix M 344 Nutrition Interventi
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Appendix N Gastrostomy Tube Feeding
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Appendix N activities. When feeding
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Appendix N Feeding Sets/Extensions
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Appendix N Fluid and Electrolytes W
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Appendix N osmolality of full-stren
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Appendix N Modular Products Modular
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Appendix N his family, and the home
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Appendix N • The feeding tube may
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Appendix N equipment. The Special S
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Appendix N Table N-2: Common Compli
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Appendix N Complication Possible Ca
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Appendix N 368 Nutrition Interventi
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Appendix O Some conditions increase
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Appendix O Table O-3: Recommended P
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Appendix O 374 Nutrition Interventi
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Appendix P Diet Prescription for Me
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Appendix Q Goals Considerations for
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Appendix R Condition Description Nu
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Appendix R Condition Description Nu
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Appendix R References 1. Ekvall SW
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Appendix S Table S-1: Infant Formul
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Appendix S Comments Osmolality (mOs
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Appendix S Table S-2: Pediatric For
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Appendix S Table S-3: Modular Produ
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Appendix S Comments Energy (kcal) P
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Appendix S Contact Information Abbo
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Appendix T Powdered Formulas Accura
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Appendix T Table T-1: Liquid Concen
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Appendix T 402 Nutrition Interventi
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Appendix U Nutrition Strategies for
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Appendix U ADA Pocket Guide to Nutr
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Glossary Autism Spectrum Disorders
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Glossary Early intervention service
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Glossary Length (recumbent length)
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Glossary Stadiometer moveable headb
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Index specialist 98 target 108 Bink
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Index elemental formula 348 elimina
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Index I ICF. See International Clas
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Index risk indicators 4 screening 1
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Index suppositories 72, 77 Surmonti
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