Nutrition Interventions for Children with Special Health Care Needs

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Chapter 20 - Nutrition Interventions for Short Bowel Syndrome Assessment Intervention Evaluation/Outcome Magnesium If deficiency, give Magnesium Protein Complex Indicators of magnesium are within normal limits. Zinc If deficiency, give zinc supplement Indicators of zinc are within normal limits. Indicators of vitamin B12 status are within normal limits. Once vitamin B12 levels are in the low-normal range, begin intramuscular shots of vitamin B12 (cyanocobalamin) every 1 to 3 months. Monitor serum level of vitamin B12 every 6 to 12 months for 3 to 5 years. (It can take years for vitamin B12 deficiency to develop.) Clinical Stool or ostomy output is less than 40—50 mL/kg/day. 2 If stool output is high, consider: Assess stool or ostomy output: • need for medical evaluation • need for intravenous fluid (patients with SBS are at high risk for malabsorption and dehydration) • If stooling though anus, obtain information regarding number and size of stools per day • If child has ileostomy or colostomy, obtain information regarding approximate volume of output each day Evaluate need to alter feeding: • may need to decrease carbohydrate and/or long chain fats • infants may need to use a modular formula so that carbohydrate and fat content can be manipulated If stool output is high, child may have bacterial overgrowth and need antibiotics. If severe, TPN may be necessary until bacterial overgrowth resolved. Child may have a viral gastroenteritis; therefore, needs careful management of fluid status until gastroenteritis resolves. 234 Nutrition Interventions for Children With Special Health Care Needs
Assessment Intervention Evaluation/Outcome Dietary Adjust recommendations for nutrient intake. Energy and protein intake is adequate to promote growth. Obtain diet history or 3 to 7 day food intake record, and analyze for energy and protein. If on parenteral nutrition, calculate energy and protein in parenteral nutrition solution, check contents of vitamin and mineral additives. (See Chapter 11 and Appendix O) Compare intake to DRI for age and to growth and weight gain. Consider: Section 3 - Condition-Specific Nutrition Interventions • energy and protein needs of infants and children with short bowel syndrome who are eating or receiving tube feedings are often greater than the DRI • infants and children on TPN may need up to 10% less energy than those fed enterally/orally because of decreased needs for diet-induced thermogenesis. It essential to avoid over feeding, as over feeding is associated with excessive fat deposition, and TPNinduced liver failure. 10 • parenteral protein needs will be the same as for enteral/oral feeding. *For reference data and guidelines for taking accurate measurements, see Chapter 2. †Height-age is the age at which the child’s current height (or length) would be at the 50th percentile on the growth chart. ‡Weight-age is the age at which the child’s current weight would be at the 50th percentile. ∫Ideal weight is the weight that would place the child at the 50th percentile weight for height (or length). Nutrition Interventions for Children With Special Health Care Needs 235
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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 292 and 293: Appendix A Please list any other nu
Page 294 and 295: Appendix A Baby formula What kind o
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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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