Nutrition Interventions for Children with Special Health Care Needs

Assessment Intervention Evaluation/Outcome
Weight and height (or length)
are increasing in appropriate
percentiles
If rate of growth (height/length, or weight) is slowing, re-assess dietary
intake and counsel appropriately
Assess growth (height or length and
weight) every 3 months
Reassess dietary intake with a 3-to-7- If diet is adequate, but growth rate continues to slow, refer to physician
day food record (if possible) and a diet to evaluate need for a change in medication or dose
history
DIURETICS Examples: furosemide (Lasix); spironolactone (Aldactone); triamterene (Dyrenium*); thiazides (Diuril, Hydrodiuril, Naqua, Hygroton,
Hydromox, and Diamox)
Consider effect of diuretic on excretion If intake of K, Ca, or Mg is lower than the DRI counsel regarding dietary Dietary intake of all nutrients
of potassium (K), magnesium (Mg), and sources. Consider mineral supplements, especially K
is adequate
calcium (Ca)
Assess diet for K, Ca, and Mg
Lab indicators of electrolyte
and mineral status are within
normal limits
If mineral deficiency is evident, counsel on dietary sources and provide
mineral supplement
If use of diuretics has been long-term,
assess electrolyte and mineral status
Section 2 - Problem-Based Nutrition Interventions
CORTICOSTEROIDS Examples: Systemic-dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone
Inhaled - triamcinolone acetonide (Azmacort)
Assess for indigestion or mild GI
Administer oral or inhaled dosage forms with food
GI distress is decreased
intolerances that may occur
Consider need for sodium restriction and/or potassium supplementation Fluid retention and electrolyte
Assess if patient receiving prolonged
disturbances are minimized
therapy with pharmacologic doses
Assess protein intake to ensure
Ensure adequate intake of protein and encourage physical activity Muscle catabolism is
adequacy
minimized.
Assess vitamin and mineral intake Supplement any vitamins and minerals that are deficient in diet.
Supplement Calcium to insure intake of 150% DRI22 Intake of vitamins, calcium,
and phosphorus is adequate
and 400 to 2000 IU
vitamin D
Assess linear growth Discuss possibility of decreased dose and/or alternate days on/off Effect on growth is minimized
medication with physician.
Assess bone density—use bone
If condition permits, exercise or physical therapy will reduce risk of Bone loss is prevented/
densiometry to diagnose osteoporosis if osteoporosis
minimized
long term corticosteroid treatment
Nutrition Interventions for Children With Special Health Care Needs 65