NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
Whether one passes or fails an academic assignment such as the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
The introduction for the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
After the introduction, move into the main part of the NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
One of the most prevalent chronic diseases in the US continues to be obesity
One of the most prevalent chronic diseases in the US continues to be obesity. The high incidence of obesity continues to pressure the American healthcare system since it significantly contributes to death, morbidity, disability, healthcare utilization, and costs (Anderson et al., 2019). Anthropometric measures and information gathering on a client’s medical history, clinical and biochemical characteristics, dietary habits, current treatments, and food security situation are all included in nutrition assessment. Nutritional status is the body’s state concerning each nutrient and its overall weight and condition, and it plays a significant role in promoting health and preventing and treating disorders.
Rapid and easy identification of individuals who may be malnourished or at risk of malnutrition and require a more thorough nutrition evaluation can be done before a complete nutrition assessment. Checking for bilateral pitting edema, evaluating weight and mid-upper arm circumference (MUAC), and asking about recent illnesses and hunger are all simple nutrition screening techniques. Standardized training is needed for nutrition screening per local and national health regulations. The paper highlights health issues identified in a 5 – year old overweight black boy with overweight parents that are full-time employees.
Relevant Health Issues and Risks
Preschoolers of color (ages 2–5) have slightly higher rates of obesity than white children. Black children, however, have greater obesity prevalence rates by age 6. Lifestyle choices like nutrition, activity level, culture, environment, and parental judgments are all connected to obesity in preschoolers (Anderson et al., 2019). Issues identified in the 5- year -old boy are age, race, family history of obesity, full-time parental employment, and grandparent’s care. A myriad of health issues, including diabetes, heart disease, sleep apnea, stress, anxiety, depression, low self-esteem, eating disorders, hypertension, stroke, asthma, cancer, breathing problems, bone, and joint disorders, gall bladder disease, infertility, eating disorders, dyslipidemia, liver problems, high cholesterol, and sleep issues are all at risk for patients with childhood obesity.
In many high-income countries, paid work has increased in two-parent and lone-parent families during the past few decades. These changes are primarily the result of more mothers entering the workforce. It has been proposed that parental employment, specifically maternal employment, is a risk factor for childhood obesity. Lack of adequate leisure outside of work has been cited as a major mechanism for a relationship between employment and childhood overweight (Fryar et al., 2018). Due to time constraints, it may be challenging to promote a healthy lifestyle, including a balanced diet and regular mealtimes, encouraging kids to participate in physical activity, limiting their screen time, and having kids walk to school rather than be driven.
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Grandparents can have a significant impact on the growth and development of their grandchildren. Parent-child care is associated with a 30% greater incidence of childhood obesity and overweight (Sadruddin et al., 2019). Some believe that “the bigger, the healthier” is still valid. Some grandparents could view a child’s larger weight as a sign of health. As a result, some kids are advised to eat larger portions and more frequently. Some grandparents may give children candy and fried foods as a gesture of love and goodwill. In some cultures, grandparents may even be more willing to excuse kids from completing duties around the house, which is a crucial exercise.
Gathering Further Information
A comprehensive history is vital in the patient’s evaluation. The Pediatric Obesity Algorithm is an evidence-based guide for diagnosing and treating obese children (Fryar et al., 2018). A healthcare provider should gain further information on the diet, activity level, family social history, including the parent’s working hours, birth and developmental history, and parental perceptions of obesity, and screen for any obesity-related complications. Because controlling these behaviors is essential to the success of any weight-management program, it is important to rule out the possibility of food-seeking behavior, bingeing, lack of satiety, purging, night-eating syndrome, and other abnormal feeding patterns.
For diet inventory, the healthcare provider should utilize the 24 – hour recall, food group, and food frequency questionnaire. The history of the breast- or bottle-feeding, the timing of the introduction of complementary foods, parenting techniques, cultural expectations, screen time, mealtime locations, bullying or social exclusion, the family’s willingness and capacity to make changes, and finally, financial constraints are all part of the family and social history. A child’s activity level should also be evaluated, along with the child’s access to secure exercise places and any necessary support for high activity levels. The practitioner must also evaluate non-academic screen time and sedentary time.
Questions posed to the parents and child include: Kindly give me a 24-hour recall of the foods you have taken. How often do you prepare homemade food? What is the estimated time you have with your child outside work? Kindly explain your house plan. What are some of the exercises and play activities that your child takes part in? Can you name some of your child’s friends? Has your child reported bullying or isolation by friends at any time? Do you give the grandmother any instructions on feeding and exercise of the child? Are there other obese family members? Do you think that your child has a weight problem? What are some of the risks the child may suffer from being overweight? What measures have you taken to deal with the issue?
Encouraging Active Parents’ Involvement
Parents serve as powerful role models for children aged 5 to 9 years, so it is highly advised that the family be involved in the care of the child who is obese. There should be a strict limit on non-academic screen time overall (Chai et al., 2019). A reduction in obesity is linked to substituting moderately intense physical activity for screen time. Children in this age range still need between 11 and 14 hours of sleep, preferably all at once, and naps cannot accomplish this during the day due to deficiencies at night. Sleep is still essential. The recommended daily caloric intake for obese children aged 5 to 9 is three meals and one or two wholesome snacks. Three servings of protein, 1-2 servings of dairy, and 4-5 servings of non-starchy vegetables should be consumed daily from each food group. They should not consume any fast food or beverages with added sugar. Children should be encouraged to try different meals, and portion amounts should be age-appropriate.
The parents should be actively involved by reading materials regarding the management of obesity. They may join hands and form support groups with parents dealing with the same issue. A nutrition plan and exercise should be developed in consultation with the nutritionist. The parents should also lose weight to serve as role models to their children in the weight management journey. The grandmother should be informed of the measures so that she can implement them when with the child. The parents should be encouraged to seek more secure jobs that ensure that either parent is available, especially after school. The patient should be encouraged that it is a gradual process that needs patience and consistency.
Conclusion
Childhood obesity is a chronic condition that can cause early comorbidity, mortality, and physical and psychological consequences. Lifestyle choices like nutrition, activity level, culture, environment, and parental judgments are all connected to obesity in preschoolers. Promoting healthy behaviors could help eliminate health disparities and enhance the quality of life. Programs should target young Black children and their families to lower the incidence of obesity. To prevent childhood obesity and overweight, nurses must offer comprehensive, culturally relevant strategies at the community, individual, and family levels.
References
Anderson, P. M., Butcher, K. F., & Schanzenbach, D. W. (2019). Understanding recent trends in childhood obesity in the United States. Economics & Human Biology, 34, 16-25. https://doi.org/10.1016/j.ehb.2019.02.002
Chai, L. K., Collins, C., May, C., Brain, K., Wong See, D., & Burrows, T. (2019). Effectiveness of family-based weight management interventions for children with overweight and obesity: an umbrella review: An umbrella review. JBI Database of Systematic Reviews and Implementation Reports, 17(7), 1341–1427. https://doi.org/10.11124/JBISRIR-2017-003695
Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2018). Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2015–2016. https://stacks.cdc.gov/view/cdc/58669
Sadruddin, A. F., Ponguta, L. A., Zonderman, A. L., Wiley, K. S., Grimshaw, A., & Panter-Brick, C. (2019). How do grandparents influence child health and development? A systematic review. Social Science & Medicine, 239, 112476. https://doi.org/10.1016/j.socscimed.2019.112476
Sample Answer for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
Given the negative long-term health effects of childhood obesity and the direct and indirect links it has to lifelong economic burdens, it is a substantial public health concern1 (Notara et al., 2019). The onset of obesity is influenced by both inherited and obesogenic environmental variables. Over 20 genetic variants are connected to the emergence of juvenile obesity through genetic investigations. In meanwhile, environmental obesogenic variables including a high-energy diet, little sleep, and little exercise also cause juvenile obesity. When addressing the incidence of pediatric obesity, parental overweight/obesity is thought of as a proxy for genetic susceptibility and/or obesogenic environment. This paper will look at possible health issues and challenges for a 2-year-old female who is a normal weight and lives with an obese mother and a normal body weight father, in addition to potential preventative strategies.
Health Issues and Risks
Families often have similar dietary habits, sedentary habits, and amounts of physical activity. If one parent is overweight or obese, the likelihood of their child being overweight rises (Fields et al., 2021). High-BMI individuals are more prone to experience weight-related health issues. They include diabetes, hypertension, and high cholesterol. Furthermore, bone and joint issues as well as breathlessness that makes playing sports or engaging in any physical activity difficult may affect overweight children and teenagers. Also, it can exacerbate asthma symptoms or cause children to develop asthma, snoring, or breathing issues at night, like sleep apnea, which is obstructive as well as a propensity to grow sooner. In addition to having irregular menstrual cycles, adult reproductive issues, and liver and gallbladder illness, overweight children may be taller and more physically mature than their classmates, setting unrealistic expectations for them to behave accordingly.
Childhood-onset cardiovascular risks factors, such as hypertension, high cholesterol, and diabetes, can result in adult-onset heart disease and stroke (Ball et al., 2019). Children who are overweight or obese might potentially benefit from treatment or prevention to avoid developing these issues as they age older. Along with dealing with emotional problems (including poor self-esteem), bullying, and rejection from peers, children may also have emotional difficulties. Children who are overweight or obese run the risk of harmful eating habits, eating disorders, depression, and substance misuse.
Additional Information
Parents may ensure their kid is obtaining or keeping an appropriate weight by monitoring growth patterns throughout time. Given the scenario presented, it will be required to take into account the toddler’s BMI in addition to other variables including family history, pulse rate, blood sugar levels, eating habits, and degree of physical activity. Moreover, a pregnancy history disclosing the presence of gestational diabetes or other pregnancy problems is required (Liberali et al., 2021). Also, the doctor must evaluate and plot earlier anthropometric data on suitable growth charts, with a focus on smaller kids’ “catch-up growth,” extremely early weight increase, and weight accumulation before pubertal maturation. Review of systems will entail keeping track of the kids’ sleeping habits and assessing their mood or eating habits.
Risk Assessment
Body Mass Index (BMI) and waist circumference are two measurements that are useful to know to analyze a person’s weight-related health more. The Body Mass Index (BMI) is a measurement of body fat centered on weight and height. If someone is underweight, normal weight, overweight, or obese, it indicates that. A person’s waist circumference can provide information on how much abdominal fat they have, which is linked to several chronic diseases, such as metabolic disorders (Fields et al., 2021). Except for assessing a patient’s fasting sugar levels and lipid profile on each patient, the decision about additional diagnostic laboratory testing is based on the toddler’s risk factor status. To create a personalized and targeted treatment strategy, it is crucial to understand the reasons for the variables perpetuating the toddler’s overweight and obesity.
Questions
It’s critical to validate the experiences of people who are at high risk for obesity and diabetes, assist them in developing explanations for changing their health-related behaviors, and accept their freedom to make that decision while assessing these kids (Rosello et al., 2020). I’ll ask the toddler’s parents a range of questions, including:
- What do you think of your child’s growth trajectory right now?
- How much food should you give your toddler at each meal?
- Should your family alter its eating routine to support the decisions of your younger children?
Mitigating Strategies
Parents must make decisions regarding their family’s diet, exercise routine, and time spent together to prevent their children from getting overweight. Parents who provide a good example for their children might encourage them to choose a healthy lifestyle. Parents are urged to adopt a whole-family strategy to keep children of all ages at a healthy weight. Making exercise and a healthy diet a family affair is crucial. As the children become older, the parent should additionally include them by allowing them to assist in meal planning and preparation. WHO advises providing suggestions on diet and physical activity to caregivers and parents in cases when newborns and children are recognized as being overweight (Dains et al., 2020). If children are obese, they should be evaluated further and a treatment strategy should be created.
Conclusion
The prevalence of childhood obesity has grown recently. Thankfully, dietary and lifestyle adjustments may typically be used to manage childhood obesity. These adjustments are critical because children who are obese are more likely to stay that way into adulthood and are also at an increased risk of developing weight-related health issues including diabetes, hypertension, liver disease, and cardiovascular disease. Children and adults who are obese may have terrible psychological side effects such as depression, social isolation, and low self-esteem.
References
Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: an interprofessional approach (9th ed.). Mosby.
Dains, J. E., Scheibel, P., & Baumann, L. C. (2020). Advanced health assessment and clinical diagnosis in primary care (6th ed.). Elsevier.
Fields, L. C., Brown, C., Skelton, J. A., Cain, K. S., & Cohen, G. M. (2021). Internalized Weight Bias, Teasing, and Self-Esteem in Children with Overweight or Obesity. Childhood Obesity, 17(1), 43–50. https://doi.org/10.1089/chi.2020.0150
Liberali, R., Del Castanhel, F., Kupek, E., & Assis, M. A. A. de. (2021). Latent Class Analysis of Lifestyle Risk Factors and Association with Overweight and/or Obesity in Children and Adolescents: Systematic Review. Childhood Obesity, 17(1), 2–15. https://doi.org/10.1089/chi.2020.0115
Notara, V., Magriplis, E., Prapas, C., Antonogeorgos, G., Rojas-Gil, A. P., Kornilaki, E. N., Lagiou, A., & Panagiotakos, D. B. (2019). Parental weight status and early adolescence body weight in association with socioeconomic factors. Journal of Education and Health Promotion, 8, 77. https://doi.org/10.4103/jehp.jehp_14_19
Rosello, R., Gledhill, J., Yi, I., Watkins, B., Harvey, L., Hosking, A., Viner, R., & Nicholls, D. (2020). Early intervention in child and adolescent eating disorders: The role of a parenting group. European Eating Disorders Review. https://doi.org/10.1002/erv.2798
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I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
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Important information on Writing a Discussion Question
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- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource
Sample Answer 2 for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
The assigned case study concerns an 8-year-old overweight male foster child. The child has normal-weight foster parents but overweight biological parents. The purpose of this paper is to describe the child’s health issues, additional information needed, risks, and strategies to encourage the caregivers to be proactive about the child’s health.
An explanation of the health issues and risks that are relevant to the child you were assigned.
The health issue associated with this child is his overweight status. The child’s overweight can be attributed to genetics since his biological parents are also overweight. Genetics is one of the main factors identified as a cause of obesity, with various studies establishing that BMI is 25–40% genetic (Kansra et al., 2021). An overweight child is at risk of being obese in adolescence and adulthood. He also has a high risk of developing non-communicable diseases (NCDs) like Type 2 diabetes, glucose intolerance, insulin resistance, hyperlipidemia, some types of cancer, fatty liver disease, sleep apnea, impaired balance, and cardiovascular diseases at a younger age (Sanyaolu et al., 2019).
Describe additional information you would need in order to further assess his or her weight-related health.
In assessing the child’s weight-related health, I would require additional information about his lifestyle preferences, environment, and cultural environment, which play a fundamental role in the increasing prevalence of childhood obesity. I would need information on the child’s diet, emphasizing his daily caloric, sugar, and fat intake. I would inquire about the types of food the child takes at home and school, portion size, and the frequency of intake as well as his food preferences, fast food consumption, and snack foods. Most fast foods usually have a high number of calories but low nutritional values compared to home-prepared foods contributing to obesity. Furthermore, common snack foods like chips, baked items, and candy increase the overall caloric intake contributing to obesity. In addition, I would inquire about his physical activity level, including the child’s hobbies, the games he like playing, and the amount of screen time (Di Maglie et al., 2022). I need information on the sports the child participates in school and how often he engages in them. Physical inactivity and increased screen time are highly associated with childhood obesity.
Identify and describe any risks, and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
There is a need to assess the consequences of the child’s overweight on his physical health, psychological wellbeing, social wellbeing, and academic performance. Childhood obesity can significantly affect a child’s physical health, emotional and social wellbeing, and self-esteem. I will need to inquire if the child has any medical conditions linked to being overweight, like obstructive sleep apnea, dyspnea on exertion, hyperlipidemia, or hyperglycemia (Sanyaolu et al., 2019). Besides, I would inquire if the child is usually stigmatized by his peers by being teased or bullied for his weight. This is because childhood obesity is one of the most stigmatizing and least socially acceptable disorders in childhood (Kansra et al., 2021). As a result, overweight/obese children are frequently excluded from activities, especially competitive activities requiring physical activity.
Further information on the child’s psychological wellbeing will include asking him about his self-esteem, self-confidence, and perception of his body image. Overweight/obese children with low self-confidence, low self-esteem, and a negative body image often face difficulties in weight management (Kanellopoulou et al., 2022). Moreover, childhood overweight/obesity negatively impacts children’s school performance. Therefore, I would inquire about the child’s school performance and if he has been lagging in his class or if his grades are dropping.
The information will be obtained by initiating the conversation with the parents in a responsive, non-blaming manner. Eli et al. (2022) explain that the providers’ attitudes and tone during conversations about children’s weight are fundamentally crucial. The nurse will invite the foster parents to reflect on the child’s situation, and the nurse will make them feel more supported and empowered. Uy et al. (2019) assert that effective conversations about children’s weight should be non-judgmental. The provider should consider the parents’ needs and prior knowledge and offer concrete and tailored advice.
Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
- What types of food do you frequently consume as a family?
- How often do you allow the child to go and play outside with his peers?
- What measures have you taken to manage his weight as the child’s caregiver?
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
The conversation about the child’s weight can offer a crucial chance of successfully encouraging the parents to be proactive in their child’s health and taking initiatives to lower the child’s weight and implement a healthier lifestyle. The nurse would encourage the parents to be proactive by inviting them to express their concerns and reflect on how to introduce lifestyle changes to the child (Ames et al., 2020). The nurse should discuss concerns about the child’s weight and eating habits and explore with the parents how to address these concerns.
The second measure is by the nurse presenting relevant information to the caregivers and having a conversation. Besides, the nurse should explain the reason behind the concern and recommendations (Uy et al., 2019). The nurse should offer the parents practical suggestions to implement appropriate resources for the child’s weight loss and allow them to decide on their interventions. Allowing the parents to decide is important since it encourages them to implement the interventions, thus promoting adherence.
Conclusion
The child’s overweight can be linked to genetics since his biological parents are overweight. Being overweight puts him at risk of NCDs like diabetes, sleep apnea, and cardiovascular diseases. Additional information that will be needed includes the child’s dietary patterns, food preferences, and physical activity levels. The nurse should allow the parents to express their concerns and propose measures to manage the child’s weight.
References
Ames, H., Mosdøl, A., Blaasvær, N., Nøkleby, H., Berg, R. C., & Langøien, L. J. (2020). Communication of children’s weight status: what is effective, and what are the children’s and parents’ experiences and preferences? A mixed methods systematic review. BMC Public Health, 20(1), 1-22.
Di Maglie, A., Marsigliante, S., My, G., Colazzo, S., & Muscella, A. (2022). Effects of a physical activity intervention on schoolchildren fitness. Physiological reports, 10(2), e15115. https://doi.org/10.14814/phy2.15115
Eli, K., Neovius, C., Nordin, K., Brissman, M., & Ek, A. (2022). Parents’ experiences following conversations about their young child’s weight in the primary health care setting: a study within the STOP project. BMC Public Health, 22(1), 1540.
Kanellopoulou, A., Antonogeorgos, G., Douros, K., & Panagiotakos, D. B. (2022). The Association between Obesity and Depression among Children and the Role of Family: A Systematic Review. Children (Basel, Switzerland), 9(8), 1244. https://doi.org/10.3390/children9081244
Kansra, A. R., Lakkunarajah, S., & Jay, M. S. (2021). Childhood and adolescent obesity: A review. Frontiers in pediatrics, 8, 581461. https://doi.org/10.3389/fped.2020.581461
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and Adolescent Obesity in the United States: A Public Health Concern. Global pediatric health, 6, 2333794X19891305. https://doi.org/10.1177/2333794X19891305
Uy, M. J. A., Pereira, M. A., Berge, J. M., & Loth, K. A. (2019). How should we approach and discuss children’s weight with parents? A qualitative analysis of recommendations from parents of preschool-aged children to physicians. Clinical Pediatrics, 58(2), 226–237. https://doi.org/10.1177/0009922818812489.
Sample Answer 3 for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN
A seven-year-old Hispanic female who is in second grade is brought in severely underweight. On physical examination, she has a weak pulse, bilateral pedal edema, and is apathetic. However, she has an overweight mother who she lives with during the week and an average-weight father who she lives with during weekends. The purpose of this paper is to address the child’s health issues and risks and create strategies to make the parents more proactive with their child’s health.
Health Issues and Risks That Are Relevant to the Child
Undernutrition directly causes micronutrient deficiencies such as iron, vitamins A and D, folate, thiamine, and zinc. As a result, the child has an increased risk of developing nutritional anemia, night blindness, rickets, poor growth, and poor muscle activity, deteriorating their quality of life (Dipasquale et al., 2020). Additionally, fat and muscle mass depletion is due to reductive adaptation, where the child’s energy source is drawn from muscle, adipose, and bone. This results in reduced muscle function, fractures,and alteration in electrolyte balance.
Malnutrition may also affect the child’s cardiac function. Reductive adaptation causes cardiac muscle loss, resulting in decreased cardiac output and low blood pressure (De Sanctis et al., 2021). In addition, there is micronutrient deficiency and alterations in electrolyte balance which alter cardiac function. Decreased cardiac output leads to poor tissue perfusion, causing delayed wound healing. Reduced cardiac output and electrolyte imbalance may further worsen renal function by reducing renal blood flow and glomerular filtration rate.
Malnutrition affects gastrointestinal function, resulting in changes in pancreatic exocrine function, intestinal blood flow, villous architecture, and intestinal permeability, reducing the gut’s ability to absorb nutrients. In addition, the colon loses its ability to reabsorb water and electrolytes, resulting in diarrhea and worsened nutritional losses. The liver is also affected, and all its metabolic, synthesis, detoxification, and excretory function are affected resulting in hypoglycemia and accumulation of toxic metabolites (Schuetz et al., 2021). Immune function is also affected, increasing the risk of infection due to innate and adaptive immunity predisposing the child to respiratory, gastrointestinal, and urinary tract infections (Fontane et al., 2023). However, due to a failed immune system, most signs of infection, such as fever, may be absent.
Additional Information I Would Need to Further Assess Her Weight-Related Health
Undernutrition causes multisystem organ dysfunction. It is thus crucial to inquire whether the parents have noticed whether the child has had persistent vomiting or diarrhea. In addition, it is crucial to note any temperature changes, signs of shock, open skin lesions, edema, dehydration, tachypnea, and cyanosis (Brits et al., 2020). I may also need to look at her growth curve to check for any previous abnormalities and compare her growth versus the standard. I would also need a mid-upper arm circumference, Z-scores, and basal metabolic index. Laboratory tests are also essential for assessing malnutrition(Kabashneh et al., 2020). Necessary tests include complete blood count, hemogram, septic screen, liver and renal function tests, urinalysis, protein tests, urea-electrolytes and creatinine test, and tests for inflammatory markers. While performing a physical exam, I would need to look for any hair, nail, eye, skin, and mouth changes, such as fissures, cheilitis, and stomatitis (De Sanctis et al., 2021). I would also need to check for distended abdomen and hepatomegaly, observe for behavioral changes, and assess for development.
Risks and Further Information I Would Need to Gain a Full Understanding of the Child’s Health
Undernutrition occurs when one does not have an adequate diet or has malabsorption conditions. In assessment of the child’s weight-related health condition, it is essential to take note of the quality and quantity of the food she takes through a food diary history (Vassilakau, 2021). Inadequate diet and non-nutritious foods like processed juices predispose to micro and macronutrient deficiencies. Additionally, it is crucial to inquire whether she has any food allergies, fads, restrictions, and preferences, as they may predispose her to undernutrition.
It is crucial to ask whether the child has any underlying medical condition that may affect the ability to swallow, digest, or absorb foods. It is crucial to assess whether they have nausea and anorexia or are taking medications that may be causing both. Additionally, it is vital to rule out any cause of dysphagia, which can limit oral intake of food (Schuetz et al., 2021). Medical conditions such as chronic diarrhea or childhood malignancies have been linked to undernutrition due to increased metabolic needs. One may also need to inquire about malabsorption disorders such as celiac disease and inflammatory bowel disease that may cause excessive nutritional loss.
Undernutrition can also be caused due to mental health conditions and feeding environments. It is thus crucial to screen for eating disorders such as anorexia and bulimia that may have an impact on the child, considering that the mother is overweight. Additionally, one may need to consider behaviors that discourage eating, such as bullying at school and childhood depression and anxiety disorders. Additionally, one may need to inquire about parental involvement in meals to inquire whether there is a source of discouragement to feeding (Engidaye et al., 2022). Lastly, it is vital to inquire about the ability of the parents to access nutritional foods and their feeding habits.
Specific Questions to Ask About the Child to Gather More Information
- What type of food do you occasionally give your child, and does she have any preferences?
- How do both of you contribute and participate in your daughter’s feeding patterns?
- Are there foods you prefer not to give your daughter, and why?
- Has your child ever been diagnosed with health conditions that may have affected her nutrition?
- Have you noticed any behavior change that may have affected your daughter’s well-being or her relationship with food?
Strategies to Encourage the Parents to Be Proactive about Their Child’s Health and Weight
The strategies I would employ to encourage the parents to be proactive about the child’s health include educating them on child nutrition. I would provide them with resources and inform them of signs of child malnutrition to empower them with knowledge to make right decisions (Vassilakou, 2021). Secondly, I would encourage the parents to involve their daughter in discussions regarding nutrition and have a feedback session with her. I would also organize regular follow-ups to monitor for improvement and highlight positive changes.
Conclusion
Undernutrition is a common malnutrition condition that affects children. It is crucial to note the effects it has on different organ systems. Causes of undernutrition are organic, inorganic, or both. It is thus crucial to identify the cause before initiating management. Active management of malnutrition in children requires parental and child’s active participation to achieve necessary nutritional goals.
References
Brits, H., Botha, L., Maakomane, W., Malefane, T., Luthfiya, T., Tsoeueamakwa, T., &Joubert, G. (2020). The profile and clinical picture of children with undernutrition admitted to National District Hospital. The Pan African medical journal, 37, 237. https://doi.org/10.11604/pamj.2020.37.237.25261
De Sanctis, V., Soliman, A., Alaaraj, N., Ahmed, S., Alyafei, F., &Hamed, N. (2021). Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta bio-medica :AteneiParmensis, 92(1), e2021168. https://doi.org/10.23750/abm.v92i1.11346
Dipasquale, V., Cucinotta, U., & Romano, C. (2020). Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment. Nutrients, 12(8), 2413. https://doi.org/10.3390/nu12082413
Engidaye, G., Aynalem, M., Adane, T., Gelaw, Y., Yalew, A., &Enawgaw, B. (2022). Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study. PloS one, 17(12), e0278756. https://doi.org/10.1371/journal.pone.0278756
Fontaine, F., Turjeman, S., Callens, K., &Koren, O. (2023). The intersection of undernutrition, microbiome, and child development in the first years of life. Nature communications, 14(1), 3554. https://doi.org/10.1038/s41467-023-39285-9
Kabashneh, S., Alkassis, S., Shanah, L., & Ali, H. (2020). A Complete Guide to Identify and Manage Malnutrition in Hospitalized Patients. Cureus, 12(6), e8486. https://doi.org/10.7759/cureus.8486
Schuetz, P., Seres, D., Lobo, D. N., Gomes, F., Kaegi-Braun, N., &Stanga, Z. (2021). Management of disease-related malnutrition for patients being treated in hospital. Lancet (London, England), 398(10314), 1927–1938. https://doi.org/10.1016/S0140-6736(21)01451-3
Vassilakou, T. (2021). Childhood Malnutrition: Time for Action. Children (Basel, Switzerland), 8(2), 103. https://doi.org/10.3390/children8020103