📋
Ch
. 8:
Growth
&
Nutrition
—
FNP
Exam
Cheat
Sheet
📌
Chapter
Anchor
Quotes
"
Nutrition
is
the
foundation
of
growth
,
development
,
and
disease
prevention
across
the
lifespan
."
"
The
nutritional
assessment
integrates
history
,
anthropometrics
,
dietary
intake
,
and
biochemical
data
."
🎯
Purpose
of
Nutrition
Energy
:
Provides
kcal
for
metabolic
processes
&
physical
activity
Substrates
:
Supplies
building
blocks
for
tissue
synthesis
,
repair
&
immune
function
Regulation
:
Regulates
physiologic
processes
via
vitamins
,
minerals
&
phytochemicals
🧪
Nutrient
Classes
Category Details
Carbohydrates
4
kcal
/
g
—
primary
energy
source
Proteins
4
kcal
/
g
—
tissue
building
&
repair
Fats
9
kcal
/
g
—
energy
dense
,
essential
FAs
Vitamins
Fat
-
sol
:
A
,
D
,
E
,
K
·
Water
-
sol
:
B
-
complex
,
C
Minerals
Ca
,
Fe
,
Zn
,
I
—
structural
&
enzymatic
Other
Water
,
Fiber
,
Phytochemicals
📊
Nutritional
Assessment
Workflow
HISTORY
:
Diet
recall
(24-
hr
),
food
frequency
,
cultural
/
religious
patterns
,
food
insecurity
screening
MEDICATIONS
:
Drug
-
nutrient
interactions
(
e
.
g
.,
methotrexate
→
folate
depletion
,
statins
→
CoQ
10)
ANTHROPOMETRICS
:
Weight
,
height
,
BMI
,
waist
circumference
,
waist
-
to
-
height
ratio
DIETARY
TOOLS
:
FFQ
, 24-
hr
recall
,
food
diary
;
screen
w
/
MNA
(
elderly
)
or
PedsQL
GROWTH
CHARTS
:
WHO
0–2
yrs
;
CDC
2–20
yrs
.
Plot
wt
,
ht
,
HC
(<3
yrs
),
BMI
-
for
-
age
≥
2
yrs
📏
Key
Measurements
&
Cutoffs
Category Adult
BMI
Underweight
<18.5
Normal
18.5–24.9
Overweight
25–29.9
Obese
I
30–34.9
Obese
II
35–39.9
Obese
III
≥
40
Children
BMI
-
for
-
age
:
<5
th
%
ile
=
underweight
· 5–84
th
=
healthy
· 85–94
th
=
overweight
·
≥
95
th
=
obese
Waist
Circ
:
Men
>40
in
(102
cm
) ·
Women
>35
in
(88
cm
) = ↑
cardiometabolic
risk
Waist
-
to
-
Height
Ratio
:
>0.5 = ↑
cardiometabolic
risk
(
universal
across
ages
/
ethnicities
)
🧠
Mnemonic
:
W
-
MIND
&
Sample
Exam
Qs
W
–
Weight
changes
&
trends
·
M
–
Medical
hx
&
meds
·
I
–
Intake
(
dietary
hx
,
24-
hr
recall
) ·
N
–
Nutritional
labs
(
albumin
,
prealbumin
,
CBC
,
lipids
) ·
D
–
Diagnosis
&
differential
Q
1:
9-
mo
-
old
'
s
weight
dropped
50
th
→
10
th
%
ile
over
3
visits
.
Next
step
?
→
Comprehensive
nutritional
assessment
incl
.
dietary
recall
&
social
hx
(
r
/
o
non
-
organic
FTT
first
)
Q
2:
Which
growth
chart
for
a
14-
month
-
old
?
👶
Lifespan
Quick
Notes
🍼
Infant
Birth
wt
doubles
~4–6
mo
;
triples
by
12
mo
Breast
milk
/
formula
exclusive
to
6
mo
;
solids
~6
mo
HC
: +2
cm
/
mo
(0–3
mo
), +1
cm
/
mo
(3–6
mo
)
🧒
Child
Gain
~2
kg
/
yr
;
grow
~6–7
cm
/
yr
(
age
2–
puberty
)
CDC
charts
2–20
yrs
;
WHO
birth
–
24
mo
Adequate
Ca
&
Vit
D
critical
for
bone
accrual
🤰
Pregnancy
IOM
Wt
Gain
:
UW
: 28–40
lb
·
NL
:
25–35
lb
·
OW
: 15–25
lb
·
OB
: 11–20
lb
Folic
acid
400–800
mcg
pre
-
conception
Iron
27
mg
/
day
during
pregnancy
👴
Older
Adult
↓
caloric
need
but
↑
protein
(1.0–
1.2
g
/
kg
/
day
)
Risk
:
B
12
def
(↓
IF
),
Vit
D
def
,
sarcopenia
Screen
with
MNA
(
Mini
Nutritional
Assessment
)
🚨
Red
Flags
&
Differentials
Unintentional
Weight
Loss
(>5%
in
6–12
mo
=
clinically
significant
):
Organic
:
malignancy
,
TB
,
HIV
,
hyperthyroidism
,
CHF
,
malabsorption
(
celiac
,
IBD
),
DM
Psychosocial
:
depression
,
dementia
,
substance
use
,
social
isolation
,
food
insecurity
Medication
:
polypharmacy
,
appetite
suppression
Failure
to
Thrive
(
FTT
) –
Infants
/
Children
:
Wt
<3
rd
–5
th
%
ile
OR
crossing
≥
2
major
percentile
lines
↓
Organic
:
GERD
,
cardiac
defects
,
celiac
,
RTA
,
CF
,
hypothyroidism
Non
-
organic
(
most
common
):
inadequate
caloric
intake
,
psychosocial
deprivation
,
poor
feeding
technique
Mixed
:
combination
of
organic
+
environmental
✅
Quick
Exam
Tips
✅
WHO
chart
=
birth
–24
mo
|
CDC
chart
= 2–20
yrs
✅
Always
STATE
measurements
before
plotting
(
ht
w
/
o
shoes
,
wt
w
/
o
heavy
clothes
)
✅
BMI
-
for
-
age
in
children
≠
adult
BMI
categories
—
use
percentiles
✅
Waist
-
height
ratio
>0.5
=
universal
red
flag
for
cardiometabolic
risk
✅
Prealbumin
=
best
short
-
term
marker
(
t
½ ~2
days
);
Albumin
=
longer
-
term
(
t
½ ~20
days
)
✅
Head
circumference
measured
until
age
3 (36
months
)
✅
FTT
non
-
organic
=
most
common
;
always
assess
feeding
&
psychosocial
environment
📝
My
Quick
Notes
High
-
Yield
Review
|
Family
Nurse
Practitioner
Boards
