Nutrition Interventions for Children with Special Health Care Needs

Assessment Intervention Evaluation/Outcome
Maintain selenium within normal
serum limits.
Selenium supplementation, start with 40 mcgs, recheck serum
values
Selenium
Increase dose as needed until serum levels are normal.
If not deficient before starting the
diet, most will become deficient
during the course of the diet.
Deficiency seen with use of the AED
Depakote.
Maintain zinc within normal serum
limits.
Supplement with 15 mgs zinc, recheck serum values. Increase dose
if needed until serum levels are normal.
Zinc
Low serum value
Clinical: Monitor side effects of diet
May be seen within the first couple of weeks of diet initiation. Transient lethargy is normal. Normal
activity returns.
Acute symptoms:
Section 3 - Condition Specific Nutrition Interventions
Lethargy
pH within normal range
Acidosis An expected side effect
In the presence of low carbon dioxide, giving ¼ tsp. baking soda
may help if child is vomiting.
Nausea/vomiting May be a sign of hyperketosis. Give 15-30 cc orange juice if ketones
are >80 mg/dL in AM or >160 mg/dL in PM and nausea or vomiting
is a problem. Baking soda, ¼ tsp. can also be used to relieve
symptoms. Encourage patient to take all of daily fluid allowance.
Dehydration can occur quickly with moderate to severe vomiting. If
no improvement within 24 hours or vomiting is severe, contact MD.
Nutrition Interventions for Children With Special Health Care Needs 253
Ketones within normal limits based
on child’s normal values.
Nausea and vomiting are diminished.
Ketone levels remain within
acceptable limits.