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Running Head: Scholarly Assignment: Nutrition Assessment

Scholarly assignment: Nutrition Assessment


Malissa Harris
Humber College

Scenario Introduction

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Scholarly Assignment: Nutrition Assessment

As a nurse I have been presented with a 17 month old male toddler, who has been
brought in for a check up by his parents. The toddler's charts show he weighs 32 pounds, and that
he is all up to date on his immunizations. While in the clinic his parents give him a snack of
Derretto Chips and a juice box. The parents tell the nurse that the child continuously insists on
being carried, and if left on the floor crawling for too long, he will then roll onto his back and cry
uncontrollably. As the child finishes his beef jerky he begins to cry.
In the case study presented to me, the 17 month old child there seems to have some
nutritional problems. The priority areas for this child's nutrition would have to be risk of diabetes
and the risk of being under nutrition. Both of these priority areas could have a lasting effect on
the infant's lifelong health.
First Priority
Type 1 diabetes, also called Diabetes Mellitus is the chronic deficiency of the insulin
produced by the pancreas, where little to no insulin is produced without any cause. The toddler
shows some signs and symptoms of this deficiency. Diabetes is not an uncommon diagnosis in
young adolescent males; in 2012 7% of Canadians were diagnosed with Type 1 Diabetes
(Statistics Canada). Objectively we can see that the toddler is always hungry and seems to
always want food. This is a clue to a diagnosis of diabetes because when someone has diabetes
their body doesn't use up as many calories as it can, instead most of the calories are voided
through the urine. This makes a person's organs and muscles weak and energy deprived, which
triggers hunger. The fact that the child insists on being carried may be a sign that the child is
experiencing fatigue and lethargy to walk on his own, which also can be seen as a symptom of
diabetes. This is because of the lack of sugar being produced, and the lack of sugar in the cells,

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Scholarly Assignment: Nutrition Assessment

which can create a lack of energy within the cells. The boys tantrum could indicate irritability
and odd behaviour, also seen as a sign of type 1 diabetes. The tantrum could also be seen as a
sign of hypoglycaemia which is the deficiency of glucose in the bloodstream, and is a sure sign
of diabetes.
Diabetes is an important priority for this child because there are quite a few symptoms
pointing towards this diagnosis.
In order to diagnose this child with diabetes a few tests would need to be taken. A
Glycated Haemoglobin Test could be take in order to diagnose this patient. This test works to
measure the average blood sugar levels for the person in the last 2 to 3 months. It does so by
measuring the blood sugar attached to haemoglobin blood cells. If the results for this test were
6.5 percent or higher the diagnosis would be type 1 diabetes. A random blood sugar test can also
be taken. This is a test taken randomly of the sugar levels in the blood, and if the results for this
test were to be a blood sugar level of over 200 mg/dL this would suggest diabetes, accompanied
by the signs and symptoms . Lastly a fasting blood sugar test can also be taken, this is when a
patient is asked not to eat for 24-hours before the blood test takes place. A result of 100 - 125
mg/dL is a prediabetes result and a two or more results of blood sugar 126mg/dL and higher
would be considered diabetic. If from these test a diagnosis for diabetes is made one last blood
test will be taken to test for antibodies common in diabetics. The presence of ketones in the urine
is what the doctor would need to fully diagnose the presence of type 1 diabetes. In order to
manage the diabetes I would need to teach the parents how to administer insulin therapy
properly, and they must be aware how to measure their child's glucose levels with blood glucose
testing strips. It is important that the parents are knowledgeable about diabetes so they can
maintain the diabetes as best they can.

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Scholarly Assignment: Nutrition Assessment

Second Priority
This child seems to be experiencing under nutrition, not because he is fed too little, but
because he seems to be fed all the wrong foods, that lack any nutrients. This is especially
evident when I objectively observe the foods being fed to the infant by his parents, while they are
in the clinic. They were feeding him foods with no nutritional value, they were all essentially
'junk foods.' The lack of nutrients can have an effect on the infant's development. The effect on
his development can be seen in his slow development to walk for the first time. Although it is
average for a toddler to take their first steps from age 12- 18 months, he's in the later months for
this to develop, which may be due to him being under nutrition. Toddlers are a population prone
to being under nutrition (Jarvis, p.202).
This would be a focused priority of mine for this child because firstly under nutrition is
in fact common in toddlers. Secondly good nutrition is very important early on in life it can
affect the development and growth of the child.
A few nursing interventions I would integrate would be; start a 24-hour recall
accompanied by a food frequency questionnaire, then I would ask the parents to keep a food
diary of the son's food intake. The purpose of the 24-hour recall is to try and get an accurate idea
of the patient's dietary patterns. I gain this information by asking the parents to recall everything
eaten within the last 24-hours by their son. Then I would proceed to ask the parents a few
questions about food frequency. These are questions to evaluate how many times a day, week or
month the patient eats a certain type of food. Completing the questionnaire can create a better
understand of the food intake taking place by the patient. After these interviews have been
completed, I would ask the toddler's parents to complete a food diary over the next 3 to 4 days. A

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Scholarly Assignment: Nutrition Assessment

food diary is when a person records everything being eaten each day without changing from their
normal eating habits (Jarvis, p.203). With a combination of these three interventions, I as a nurse
can gain a better understanding if the infant has a healthy diet full of nutrition. I can also better
evaluate what may need to be changed in his diet in order to maintain optimal health and
promote healthy child development.
Conclusion
This young child most likely lack nutrition and is at risk of diabetes mellitus. There needs to be
some changes made in this infants life, by his parents, so his future health doesn't worsen as he
gets older. His parents need to have a better nutrition plan for him and start feeding him with
foods that are beneficial for his growth and development. At such a young age it is important that
his parents start him on a health living. After being diagnosed with diabetes it is crucial for the
child to treat and maintain his diabetes. If the parents do not follow the nutritional outline and
treatment, the child may suffer the consequences of their bad habits.

Refrence Page

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Scholarly Assignment: Nutrition Assessment

Care of Children and Adolescents With Type 1 Diabetes. (22005). American


Diabetes Association, 28(1 186-212). Retrieved from
http://care.diabetesjournals.org/
James, R. (2013, September 19). Diabetes, 2012. In Statistics Canada.
Retrieved October 28, 2014
Jarvis, C. Physical Examination and Health Assessment, Canadian Edition,
2nd Edition. Saunders Canada, 2014. VitalBook file.
Type 1 diabetes in Children (2014, April 1). In Mayo Clinic. Retrieved October 28, 2014
Whiteman, Honor. (2014). Parents 'increase infant's obesity risk through feeding and activity
practices. Medical News Today,

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