Krause\'s Food & the Nutrition Care Process 14th edition CLINICAL CASE STUDY Cha
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Question
Krause's Food & the Nutrition Care Process 14th edition CLINICAL CASE STUDY Chapter 16
Ethan is an 8-month-old male who was born vaginally at 37 weeks gestational age. The pregnancy and delivery were uncomplicated. This was his mother’s second pregnancy. Ethan’s brother, who is now 4 years old, was born prematurely at 27 weeks gestational age.
Ethan’s mother is concerned that Ethan is underweight and not eating enough food. Ethan was born small for gestational age and weighed less than 5 lb at birth. His weight and length percentiles have increased. His weight has followed the 5th percentile for age and his length has followed roughly the 50th percentile for age since 2 months of age. His weight for length has consistently been between the 2nd and 5th percentiles.
Ethan’s mother offers him Similac Advance formula mixed at standard dilution 6 to 8 times daily. Ethan’s mother has a hard time reading Ethan’s hunger cues. She is so concerned about his growth that she offers him a bottle frequently, every 1 ½ to 2 hours. He consumes 26 to 30 ounces (780 to 900 ml) of formula daily. She offers him homemade purees of fruits or vegetables mixed with grains twice daily; he eats a couple of tablespoons at a time. When she feels he has not eaten enough food, she offers him a bottle.
1-What additional information is needed to get an accurate assessment of this infant’s intake?
2-What are your expectations for Ethan’s growth?
3- When would you have concerns about Ethan’s growth?
4- What age appropriate hunger cues will you review with Nathan’s mother?
5- What age appropriate satiety cues will you review with Nathan’s mother?
6- Ethan’s mother would like to switch to cow’s milk rather than the expensive infant formula and it would be easier with her other child to just have to buy one type of milk. What will you tell her?
7-At Ethan’s current weight of 14.5 pounds, how many calories does he need each day?
8- What developmental feeding skills would Ethan demonstrate he is ready for self-feeding?
9-What will you tell Ethan’s mother about BPA?
10- Ethan’s mother likes to put Ethan to bed with a bottle, what will you tell her?
Explanation / Answer
I shall answer the first four sub questions :
1. Additional information required for assessment of intake : History of breastfeeding , Age at introduction of complementary foods, any problems in infant like comiting / diarrhea / constipation, any data to diagnose or confirm nutritional deficiencies.
2. Ethan was born small-for-gestational age. He has since tried to compensate for the same. His length indicates there is absence of chronic malnutrition. His weight will soon catch up with his length and he shall follow a normal growth curve subject to he not being force fed.
3. If Ethan's weight falls below the 5th percentile, it would be a cause of concern.
4. Age appropriate hunger cues in Ethan :
a. Reaches for food
b. Points to food
c. Gets excited when food is offered.
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