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Peds Ch 10

Test 1

Failure to Thrive (FTT) Growth failure, sign of inadequate growth resulting from inability to obtain or use calories. Common criteria is weight (and sometimes height).
Cause of FTT 1. Inadequate calorie intake 2. Inadequate calorie absorption 3. Excessive calorie expenditure. Often involves a combo of infant disease, dysfunctional parenting, & poor parent-infant bonding. Primary etiology is always inadequate cal intake.
Other factors that lead to inadequate calorie intake *poverty *health or child rearing beliefs like fad diets *inadequate nutritional knowledge *family stress *feeding resistance *insufficient breast milk intake
Diagnosis of FTT If recent, weight not height is below acceptable levels. Longstanding, both weight and height are low indicating chronic malnutrition. Complete HH and dietary history, physical exam, developmental assessment, fam assessment, 24hr food intake or 3-5 day.
FTT lab tests *lead toxicity *anemia *stool-reducing substances *occult blood *ova and parasites * alkaline phosphatase *zinc
Hospitalize if... * evidence of SAM *child abuse or neglect *significant dehydration *caretaker substance abuse or psychosis *outpt mgmt that does not result in weight gain * serious infection
FTT prognosis Children who had FTT s infants are at risk for shorter heights and delayed development. IQ scores are significantly lower than peers w/o history of malnutrition.
Nursing mgmt of FTT *Assess child, parent, family interactions *Accurate assessment of weight, height and food intake *Learn to perceive child's cues and reverse cycle of dissatisfaction *Family systems approach
4 FTT goals 1. achieve ideal weight for height 2. allow for catch-up growth 3 restore optimum body composition 4. educate parents regarding child's nutrition requirements
Created by: tkulwicki