Question

Pediatric Nutritional & Developmental Assessment

Answer 1

Nutritional Assessment description include profile of the child and familys eating habits. Nutritional assessment is done by determining dietary history ,performing clinical examination and obtaining biochemical analysis.

Dietary history include

• 24 hour recall:ask family to recall all food and liquid intake during the past 24 hours.
• Asking family to keep a 3-day record of all food and liquid intake.
• food frequency record,by providing a questionaire and ask family to record information regarding the number of times per day ,weeks or month a child consumes items from the four food groups.

Perform clinical examination

• Assess skin,hair,teeth,gums,lips tongue and eyes.
• Use anthropometry ;measurement of height,weight,BMI,head circumference in young children,proportion ,skin fold thickness and arm circumference.Height and head circumference reflect past nutrition.Weight,skinfold thickness and arm circumference reflect present nutritional status ;especially protein and fat reserves.Skinfold thickness provides a measurement of the bodys fat content;one-half of the bodys total fat stores are directly beneath the skin.

Obtain Biochemical analysis

• Plasma,blood cells,urine or tissues from liver,bone ,hair or finger nails can be used to determine nutritional status.

Laboratory tests Hgb,Hct,albumin,creatinine and nitrogen are commonly used to determine nutritional status.

Developmental Assessment of Infant include

1.Physical Assessment

• Height increases by 3/4inch per month.
• Weight is doubled at 5 to 6 months and tripled at 12 months.

Head assessment includes assessing for symmetry and shape and auscultation for breathsounds

Eyes- colour of sclera,tears for signs of dehydration.

Ears--presence of symmetry in position which is determined by considering an imaginary line from corner of eye to top of ear.

Nose -test for patency

Mouth and throat-Dentition,condition of teeth,mucous membranes,tongue,pallet,uvula and tonsils.

Respiratory- inspect shape of the chest,percuss for dullness,palpate for vibration.

Cardiac assessment- past medical problems,assessment changes in skin colour,heart sounds,clubbing .

GI assessment- Auscultation of bowel sounds.,Inspecting abdomen for protrusion,sunken,masses,symmetrical .

Percussion-should sound tympanic.

Genitalia-testicles for swelling,hydroseal,position in male.In female vaginal orifice is assessed for presence/absence of hymen.

2. Anthropometric measurement-Vital signs of an infant is Temp-97-99F,heart rate-90 to 130b/mt,respiration-20 to 40 breaths/min.Blood pressure-90/56mmHg.

3

3 Nutritional Assessment is done.

4 Infants skill are assessed.