Download Pediatric Critical Care (PICU) Exam Questions & Answers (Grade A+) and more Exams Pediatrics in PDF only on Docsity!
Questions & Answers (Grade A+)
Describe differences in nutrition assessment between a pediatric and an adult pt - correct answer ✅· Diagnoses · Congenital (at birth) vs chronic disease · GROWTH > Maintenance · Multi-factorial, ever—evolving · Irreversible complications · Direct pt communication antrometrics in pediatric pt - correct answer ✅o weight o length/height o WT/L or BMI, o MUAC- mid upper arm circumference to determine muscle and fat stores o TSF- triceps skin fold thickness to monitor changes in body fat o FOC/HC- frontal occipital circumference or head circumference markers for severe chronic & malnourished babies up to 4 months
Questions & Answers (Grade A+)
what anthropometric helps determine muscle and fat stores - correct answer ✅MUAC (mid upper arm circumference) what anthropometric monitors changes in body fat - correct answer ✅TSF )tricep skin fold thickness) what anthropometric are markers for severe chronic & malnourished babies up to 4 months - correct answer ✅FOC/HC- frontal occipital circumference or head circumference Growth charts: - correct answer ✅o Percentiles vs. Z scores § Z: what to use 3-97% once out of the normal range § Don't quantify the nutrition- growth § How far off of the standard deviation; tell you more. Want to use when off so tell you if pt getting better when do you use z scores - correct answer ✅when out of normal range of 3-97%
Questions & Answers (Grade A+)
§ Delayed tooth eruption asosc. with severe malnutrition § Liver disease -> green teeth (high bilirubin levels) NFPE: skin & nails - correct answer ✅o Skin turgor: § Small children: abdomen § Adolescents: back of hand, forearm or chest NFPE: abdominal cavity - correct answer ✅o Flat: indicative of undernutrition in infants o Protuberant/round: normal, healthy in infants 3 categories for estimating energy needs: - correct answer ✅1. maintenance metabolic needs
- energy required for growth
- digestion energy needs: evaluating growth/size: - correct answer ✅o Normal growth/normal energy needs
Questions & Answers (Grade A+)
o Underweight -> catch up growth -> increased energy needs o Overweight/obese -> catch down -> possible decreased needs energy needs: identify ideal body weight % - correct answer ✅o Weight for age %ile o BMI for age %ile o Not always 50th %ile gold standard for energy needs - correct answer ✅indirect calorimetry energy needs: predictive equations: - correct answer ✅o Schofield (used most -subj. uses stress factors) o WHO o Harris-Beneditc o Developmental disabilities o Stress factors o ASPEN critical illness guidelines
Questions & Answers (Grade A+)
pediatric specific PN complications: - correct answer ✅- TPN associated liver disease
- metabolic bone disease
- aluminum contamination toxicity
- iron def. anemia- iron not added to TPN solutions prematurity: - correct answer ✅o Increased overall nutrient needs o Increased phos and Ca needs malnutritioin: - correct answer ✅o Goal: blunt cause of malnutrition o Promote catch up o NFPE important cystic fibrosis: - correct answer ✅o Asses: vitamin therapy, stooling pattern, abdominal pain/gas, enzyme regimen o High kcal/pro o Supplemental NS o High sodium
Questions & Answers (Grade A+)
burns: - correct answer ✅o Galveston equations used/Body surface area/burn surface area o Very early EN initiation significantly beneficial (6- hr ideal) o Vitamin supplementation wounds: - correct answer ✅o Protein 1.5-2x RDA o Vit C & Zn supplement only if def. congenital heart disease: - correct answer ✅o 8 in 1000 births o Increased energy requirements o Decreased energy intake cancer: - correct answer ✅o WHO equation + stress factor 1.3- o Pro: § O-2 yr: 2-3 g/kg § 2-13: 1.5-2 g/kg
Questions & Answers (Grade A+)
o IV lipids, glucose & insulin o Nitrogen/ammonia scavenging therapy o Dialysis & SCMO gastrointestinal disease: - correct answer ✅o Stooling aids- sure-jello certo (pectin), fiber, green beans (pectin) trauma - correct answer ✅avoid overfeeding surgery: perioperative period - correct answer ✅§ fluids used to maintain perfusion § decreased overall energy needs § weight/fluid shifts surgery: post-operative period: - correct answer ✅-cholestasis
