Malnutrition And Growth Faltering ✅

Question 1

What % of children in hospital are malnourished?

Answer 1

20-40%

Question 2

What does the rate of malnutrition in hospitalised children depend on?

Answer 2

• Population

- Type of hospital

Question 3

What problems can malnutrition in hospitalised children cause?

Answer 3

• Longer hospital stays
• Poorer clinical outcomes
• Significant cost implications for health services

Question 4

What often happens to nutritional status during hospital stays?

Answer 4

It deteriorates

Question 5

Why does nutritional status often deteriorate during hospital stays?

Answer 5

Due to effects of treatment or surgery

Question 6

How is the problem of malnutrition in hospitalised children being addressed?

Answer 6

Increasing emphasis on identifying children who are either malnourished on admission or who may become so whilst in hospital

Question 7

How are children who are malnourished or at risk of it identified?

Answer 7

Number of screening tools have been developed

Question 8

Give 3 screening tools for the identification of malnourishment/risk of

Answer 8

• PYMS
• STAMP
• STRONGkids

Question 9

How do screening tools identify children who are/are at risk of malnourishment?

Answer 9

Combine simple antropometric mesures with other parameters in order to score and categorise children

Question 10

Give 3 parameters that may be considered in nutritional screening tools

Answer 10

• Subjective observations of ‘wasting’
• Underlying disease
• Likely impact of planned treatments on nutritional status

Question 11

What is done with children identified as being high risk on nutritional screening tools?

Answer 11

Targeted for additional dietetic or nutritional input

Question 12

What is the limitation of existing nutritional screening tools?

Answer 12

Have not been shown to improve patient outcome or reduce hospital stay in children

Question 13

What can malnutrition in sick children arise from?

Answer 13

• Inadequate intake
• Increased requirements
• Excessive losses

Question 14

What is required in the management of a malnourished child?

Answer 14

• Assessment to identify main factors

- Plan appropriate mangement

Question 15

What is nutritional management currently largely based on?

Answer 15

Monitoring weight

Question 16

What is the limitation of using weight monitoring to guide nutritional management?

Answer 16

Can be misleading, as recognised that in children with a variety of chronic diseases, aiming to promote weight gain may result in incrased fat mass rather than promoting linear growth or lean mass, which might be clinically more favourable

Question 17

What is the limitation of the definition of growth faltering or malnutrition in high-income settings?

Answer 17

Inconsistent and depends on context

Question 18

What does growth faltering generally refer to?

Answer 18

Infants who are not growing as expected

Question 19

What should growth faltering be diagnosed on the basis of?

Answer 19

A pattern of growth (rather than single measurement)

Question 20

What is mild growth faltering often described as?

Answer 20

A fall in weight across 2 centile lines

Question 21

What is severe growth faltering often described as?

Answer 21

A fall in weight across 3 centile lines

Question 22

What is the aim of defining faltering growth in terms of crossing centile lines?

Answer 22

Identiying extremes of the population

Question 23

What % of children will cross 2 centile lines between 6 weeks and 1 year of age?

Answer 23

5%

Question 24

What % of children will cross 3 centile lines between 6 months and 3 years of age?

Answer 24

1%

Question 25

What needs to be taken into account when interpreting growth charts to identify growth faltering?

Answer 25

The growth reference

Question 26

Why does the growth reference need to be taken into account when assessing for growth faltering?

Answer 26

As the pattern of growth may appear different on different growth charts

Question 27

How is undernutrition in older children generally described?

Answer 27

In terms of BMI or weight-for-height

Question 28

What factors must be taken into account in the management of infants and children with poor growth?

Answer 28

• Parental
• Socio-economic
• Psychological
• Nutritional intake
• Feeding patterns
• Symptoms and signs suggestive of underlying organic cause