Nutrition Interventions for Children with Special Health Care Needs

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Chapter 18 - Nutrition Interventions for Congenital Heart Disease Defect Description Symptoms Treatment Growth/Developmental Implications CHF Primary closure Highest frequency of severe growth failure (>2 std dev below mean); poor feeding; slow weight gain Most common heart defect - “Hole in heart”; abnormal opening between the right and left ventricle VSD (Ventricular Septal Defect) Direct closure of defect or patch graft Normal growth unless lesion is severe, then poor weight gain Asymptomatic or mild respiratory symptoms; may not be detected until school age Abnormal opening between the right and left atria ASD (Atrial Septal Defect) Valvotomy Growth failure noted in 16% of patients Variable presentation; narrowing worsens with growth. Aortic Stenosis Obstruction to the left ventricular outflow; aortic valve is thickened and narrowed leading to ↑ pressure in L ventricle Growth normal with simple defect; linear growth affected more than weight 208 Nutrition Interventions for Children With Special Health Care Needs Medical management, balloon angioplasty, or surgical repair Elevated upper extremity blood pressure; congestive failure Narrowing of the aortic lumen Coarctation of the Aorta Surgical repair Poor feeding; slow weight gain Difficulty breathing; impaired renal function Part of aorta absent leading to severe obstruction of blood flow to lower part of body; PDA initially allows flow but after closure BP in lower circulation inadequate Interruption of Aortic Arch Variable presentation Valvotomy Normal growth unless lesion is severe; linear growth affected more than weight Obstruction to R ventricular outflow Pulmonary Stenosis
Table 18-2: nuTriTion inTervenTions for CongeniTal HearT disease Assessment Intervention Evaluation/Outcome anthropometric* Adjust recommendations for energy intake, based on growth Rate of weight gain and growth are appropriate Measure and plot on appropriate growth chart: • Height or length for age • Weight for age • Weight for length or BMI • Head circumference (under 3 years) Repeat height/length, weight and OFC measurements at every child visit Section 3 - Condition-Specific Nutrition Interventions Indicators of fat and muscle stores within normal limits Adjust recommendations for energy, protein intake based on measurements Measure: • Triceps skinfold • Mid-upper arm circumference Nutrition Interventions for Children With Special Health Care Needs 209 Calculate: • Arm muscle circumference • Arm fat area Obtain all available previous measurements. Compare all current measurements to reference data for chronological age and to previous measurements Biochemical Serum transferrin saturation and MCV are within normal limits If iron deficiency is evident, supplement with iron while carefully monitoring hematocrit, hemoglobin, MCV, and serum transferring saturation: Note: hematocrit and hemoglobin are often elevated because of an increased number of red blood cells (polycythemia) to compensate for the cardiac defect; iron deficiency may exist even if hematocrit and hemoglobin levels are high; children with congestive heart failure may have chronic constipation, which can be aggravated by iron supplements Evaluate iron status: • MCV ( mean corpuscular volume) • Serum transferrin saturation
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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 8 - Oral-Motor Feeding Prob
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Chapter 9 - Behavior Issues Related
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Chapter 10 - Enteral Feeding Other
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Refere
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Chapter 11 - Community Monitoring o
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Chapter 12 - Accommodating Special
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Chapter 13 - Nutrition Intervention
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Page 174 and 175: Chapter 14 - 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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Nutrition Interventions for Children with Special Health Care Needs

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