Planning Nutrition Therapy for a Complex Pediatric Patient
Order Description
Unit outcomes addressed in this Assignment:
List the major factors that influence the recovery of a sick child.
Explain three methods of improving nutrient intake in a pediatric patient with a chronic disease.
Course outcomes addressed in this Assignment:
NS335-5: Design a realistic and therapeutic meal plan for a patient with a severe food allergy or disease that prohibits certain types of foods or nutrients.
GEL-8.3: Formulate a logical solution to a problem.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Unit 8 Assignment
Unit outcomes addressed in this Assignment:
List the major factors that influence the recovery of a sick child.
Explain three methods of improving nutrient intake in a pediatric patient with a chronic disease.
Course outcomes addressed in this Assignment:
NS335-5: Design a realistic and therapeutic meal plan for a patient with a severe food allergy or disease that prohibits certain types of foods or nutrients.
GEL-8.3: Formulate a logical solution to a problem.
Instructions:
Imagine that you are a nutrition assistant working at a pediatric rehabilitation center. This rehabilitation center provides care for pediatric patients who are recovering from recent hospitalizations. This facility is considered to be the bridge between hospitalization and home care.
The supervising dietitian has informed you that a new patient was admitted overnight from the nearby hospital and is recovering from a skin graft surgery due to a severe pressure ulcer (bed sore). Imagine that you are asked to review the patients chart notes and provide a nutrition assessment summary along with some ideas about what type of therapeutic diet or nutrition therapy she requires.
Patient information from the hospital medical chart:
Name: Cindy
Age: 6-year-old female
Height: 43 inches
Weight: 38 pounds
Admitting Diagnosis (Dx): Cerebral Palsy bedridden stage 3 pressure ulcer on sacrum food allergy to eggs
Surgery: Skin graft performed to increase healing and reduce further infection risk.
Diet order: Thickened liquids and pureed foods with precautions due to dysphagia (swallowing deficiencies) associated with CP. No eggs: Severe Egg Allergy.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Speech/Cognitive: Patient receives speech and swallowing therapy due to CP. Her speech and cognitive abilities were reported to be around that of a 2-year-old.
Cindy normally resides at home with her family. She qualifies for state-funded home medical assistance due to the CP diagnosis. She is bedridden and relies on the home health nursing assistants for care. Her parents have three other children and involve her in as many family activities as possible but the actual care is provided by the in-home medical team. Cindy has had a gastrostomy feeding tube (G-tube) since she was just a few months old. In recent years it has only been used nocturnally if her oral intake of the pureed/soft diet foods fell below the 50% mark for two or more meals. She received a specialized enteral formula that did not have eggs as any source of the protein.
For many years Cindy was cared for by the same team of nurses and nursing assistants and she did not have any major medical or nutrition-related problems. However about 6 months ago the state funded program changed home care contract companies and a new company began to provide care. Cindys parents felt that the care was sub-standard and reported it numerous times but without any improvements. It was not until Cindys quarterly check-up that these problems were identified. Her weight had dropped by 15% in just 3 months her albumin was low and her lean muscle mass and strength had decreased. Most alarmingly she had developed a pressure ulcer on the sacrum. The MD immediately admitted Cindy into the hospital.
Upon further investigation the new home health company had been administering nocturnal tube feedings with a formula that contained egg as one of the partial sources of protein. They thought that it was a comparable substitute for the previous brand. Additionally they had misread the original nutrition order to only give night enteral feedings (via the G-tube) if her oral intake was insufficient. Until the issues were discovered Cindy went several months receiving a full night of tube feedings that provided a feeling of fullness to her. She also was suffering from chronic diarrhea and associated malabsorption. Subsequently she would not feel well enough to eat the next day and the cycle repeated itself daily. She also started having many more nasal and respiratory symptoms which the new care providers explained away as being typical seasonal allergies. She was prescribed an antihistamine. Her parents were unaware of the nocturnal tube feedings because the nursing staff would run them about 810 hours while the patient was asleep.
Questions to address:
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
1. Why was Cindy at risk for a pressure ulcer? What were some of the contributing factors and why?
2. What are the symptoms of an egg allergy? Why do you think her allergy was not ever life threatening when she was receiving the nightly tube feedings at home?
3. Take into consideration her multiple medical conditions of cerebral palsy egg allergy and recent pressure ulcer and calculate her estimated calorie needs and protein needs.
4. Recommend an appropriate tube feeding formula brand name or type that has no albumin from egg protein (for the days that she does not have adequate oral intake of her meals).
5. Appendix: Design a full-day meal plan for Cindy that includes pureed/soft foods. This diet needs to fully address her CP-related chewing/swallowing challenges. Be sure to consider her protein needs for wound healing promotion and future prevention but without foods containing eggs or egg by-products. Oral protein drink supplements can be considered. Include the total calories carbohydrates fats protein and any micronutrients that are important in this case.
Requirements: Please include the answers to questions 14 in an essay of at least 2 pages in length. Incorporate at least three references in APA style within the essay. Part 5/Appendix should be formatted as a well-organized 1-day sample meal plan with a detailed description of the food items and accurate serving size. The meal plan is in addition to the 2 pages for questions 14.
Submitting your work:
Submit your Assignment to the appropriate Dropbox. For instructions on submitting your work view the Dropbox Guide located under Academic Tools at the top of your unit page.
Please be sure to download the file Writing Center Resources from Doc Sharing to assist you with meeting APA expectations for written Assignments.
To view your graded work come back to the Dropbox or go to the Gradebook after your instructor has evaluated it. Make sure that you save a copy of your submitted work.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Unit 8 Assignment Grading Rubric = 150 points
Assignment Requirements
Points possible
Points earned by student
Student answers each of the following:
Why was Cindy at risk for a pressure ulcer? What were some of the contributing factors and why?
025
What are the symptoms of an egg allergy? Why do you think her allergy was not ever life threatening when she was receiving the nightly tube feedings at home?
025
Take into consideration her multiple medical conditions of cerebral palsy egg allergy and recent pressure ulcer and calculate her estimated calorie needs and protein needs.
025
Recommend an appropriate tube feeding formula brand name or type that has no albumin from egg protein (for the days that she does not have adequate oral intake of her meals).
025
Appendix: Design a full-day meal plan for Cindy that includes pureed/soft foods. This diet needs to fully address her CP-related chewing/swallowing challenges. Be sure to consider her protein needs for wound healing promotion and future prevention but without foods containing eggs or egg by-products. Oral protein drink supplements can be considered. Include the total calories carbohydrates fats protein and any vitamins or minerals that are important in this case.
040
Required amount of APA style references are used within the paper to effectively support ideas.
010
Total (Sum of points earned)
0150
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
The Proposal is written in the most current version of APA format with no grammatical spelling copyright plagiarism or proofreading errors.
Points deducted for spelling grammar and/or APA errors.
Adjusted total points earned
Instructor Feedback*:
*Instructor may also leave feedback comments within Assignment submission.
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