Nursing Biology and Kids Health Care - Case Study Example

Nursing Biology Jasmine, a ten month old child is admitted to a hospital for poor growth and malnutrition. She weighs only 6 kilogram and still liveson solid food and has not been weaned to solid foods. The first year of an infant is a time of rapid change. During this period, a baby will grow quickly. By the end of the first year, on an average, an infant will grow 25 centimetres in length and gains almost three times of her birth weights. After the first birthday, the growth rate slows considerably. A ten months old infant, usually sit unassisted and unsupported. She will also able to pull herself up to a standing position and can crawl on her abdomen. “At the end of their first year, the culmination of development in skeletal, muscular, and neural systems allows infants to make the critical transition to walking upright.” (Infant Growth and Development. 2006). A ten-month-old child improves her communication skills. She is testing new sounds. A good nurse should encourage her interest in language by carefully listening and replying to her words. There are several things a nurse can do to ensure that a child grows and develops normally. In jasmine’s case, make sure that she gets the following. Enough rest: - sleep patterns differ by individual child by most children need 10 to 12 hours of sleep daily. Sleep provides rest, which the body requires to grow properly. Proper nutrition: - a balanced diet which will provide all the essential minerals and vitamins required for normal growth and development. The development of a child from birth to 5 year can be measured in five ways. Social: - how a child feels and reacts to the surroundings. Language: - how a child learns words, sound and sentence. Cognitive: - how a child thinks and learns. Motor skill: - how a child learns to crawl, sit up and run. Social/emotional development Most babies around 10 months old start showing fear around strangers. They get upset when the parents go somewhere, and they show separation and anxiety. At this stage, a child may closely look at peoples facial expressions especially when he/she need assistance in deciding what to do. Cognitive development At this stage, a child learns to use objects correctly. For instance, using a phone or drinking from a cup. She will be able to correctly identify an image when its name is spoken. She also tries to explore objects in many ways such as banging, shaking, dropping and throwing. She will also able to identify between two or three object. Language Regarding language development, babbling appears more advanced and, more or less, it sounds like language. She started to using sounds and gestures to communicate and able to respond to simple verbal requests. She will be able to utter ‘mama’ and ‘dada’. Sensory Development Even though most senses of a 10-month-old child is mature; her hearing and vision improves till twelve months. “By the seventh month most children have full color vision and they can see object at a distance more clearly”. Motor Development Regarding motor development, babies reach many important mile stones before their first birthday. They are able to sit without assistance, releases hands for holding things and dropping them, crawl forward on belly, walks holding on to furniture, puts things in and out of container and tries to copy scribbling. The physical growth of a child differs from his/ her mental growth. Childs physical growth “refers to the increases in height and weight and other body changes that occur as a child matures. Hair grows; teeth come in, come out, and come in again; and eventually puberty hits. Its all part of the growth process.” (Your Child’s Growth. 2007). Everyone has to take good care of an infant’s diet, as it would be fuel for his or her natural growth and development. In Jasmine’s case, dairy foods should be included in the diet as it plays a significant role in developing strong teeth and bones and preventing osteoporosis. Besides calcium, it is a very source of vitamin A and D, minerals and protein. The breast milk is recommended for the first six months, and small qualities of semi- solid food can be given infants older than six months. Since Jasmine is 10 months old, cheese cubes/slices may be introduced in the diet. In order to provide jasmine food from all the four basic food groups of healthy diet pyramid, introduce a different food item every week. One-week space will allow you to find out whether the food creates an allergic reaction in child or not. There is a general tendency shown by infants around 10 months year old is that they tend to develop a likeness for some type of foods and refuse to eat other baby foods, this depriving them of a balanced diet. The diet of jasmine should include mineral. But adding mineral oil to finger foods may be difficult, so it should be included in other type of foods. At this age, jasmine needs probably 750-900 calories a day. She needs calcium much more that as she did at birth. Iron, which supports growth and development, should be an essential part of her diet. Iron plays a crucial role in forming haemoglobin, which carries oxygen to the body’s tissues. It is also very important in brain development. Food items such as beef, poultry, fish, pork, and beans are all very good sources of iron and protein. It is possible that infants, aged around 10 months old will be taking less food than they were before. There is no need for worry if jasmine eats less. It may be due to the growth slowing down at this time. “So she may simply feel less hungry than before. Continue to offer a wide variety of foods and be patient; shell let you know when hes hungry.” (Making Baby Food for Your 10-12 Month Baby. 2005). It is very evident that jasmine is malnourished. Malnutrition Malnutrition is one of the important causes of mortality and morbidity among children across the world. The World Health Organization defines malnutrition as "the cellular imbalance between supply of nutrients and energy and the bodys demand for them to ensure growth, maintenance, and specific functions.” (Malnutrition. 2006). Malnutrition can lead to developmental problems, fractured bones, a distended abdomen, rickets, and lung disorder. Due to insufficient supply of proteins and energy supply, young babies suffer from poor weight again, slower liner growth and behavioural changes. Balanced Diet Balanced diet means a diet, which contains a combination of different food types including pulses, grains, vegetables, fruits, fat, dairy products and oils. A balanced diet should be able to provide all the essential nutrients for normal growth and development of an individual. It may be defined in the following manner “a diet which contains all the nutrients e.g. energy, proteins, fats, vitamins, minerals etc. required by a child for the proper maintenance of health and optimum growth is termed a balanced diet” (Diet and Nutrition. 2005). There are many advantages of balanced diet. One of the important advantages is that its balanced and can give you everything you need, so you are healthy and lose weight as well. They allow you to maintain weight control naturally rather than having to give up a food group or do to fad or crash diets which are un healthy and dont work. (Balanced Diets – for Quick & Healthy Weight Loss. 2007). A balanced diet will give you more energy to meet the daily requirements. It is also highly useful in preventing chronic diseases. Micronutrients “Micronutrients are vitamins and minerals that boost the nutritional value of food.” (Micronutrients. 2007). When children’s daily diets do not contain adequate quantities of micronutrient, the out come can have drastic consequences; growth is stunted, they do not reach their full intellectual capacity, and blindness may occur. Important micronutrients are iodine, iron, and vitamin A, C, E, D and foliate Zinc and Calcium. Iodine deficiency leads to brain damage and mental retardation and infant mortality. The best method is to eliminate iodine deficiency is through salt iodization. Vitamin A is a crucial micronutrient for the immune system. It is estimated that at least 100 million children under five suffer from vitamin A deficiency. Macronutrients Important macronutrients are carbohydrates, fibre, fat, polly unsaturated fatty acids, saturated and trans fatty acids, protein and amino acids. Carbohydrates are primary energy source for brain and provide calories to maintain body weights; main sources of carbohydrates are grain, vegetgtables, fruits, and juices. Fiber improves lactation, decreases risk of corny heart disease; grains such as oats, rice, and wheat are good source of fiber. Fat improves the absorption of fat-soluble vitamins. Main sources of fat are butter, vegetable oils, whole milk, meat, poultry products, seeds, nuts, and bakery product. Polly unsaturated fatty acid is a crucial components of a structural membranes lipids. Nuts, vegetable oils and seeds are good sources of fatty acids. Protein and amino acids are the major components of all cells in the body and work as enzymes. Main sources of proteins are meat, poultry, eggs, milk, fish, yogurt, and cheese are important sources of proteins and amino acids. The diet of jasmine should include both micro and macro nutrients. Meat and starchy foods such as potatoes, rice, and noodles can be given to child who is 9 month old. Since jasmine is 10 month old, table foods such as mild casseroles, cheese, beans, vegetables, fruits, and breads can become a part of diet. It is often observed that when child is close to one year old, he/she becomes picky about the food. Child develops definite likes and dislikes and feeding probably becomes a nightmare. At this stage, parents must trust the child’s interest and give them some freedom when it comes to eating. Parents get worried that poor eating can lead to developmental problems and nutritional deficiency. When child eats very less mealtime becomes a battleground as the worried parents persuade their children to eat. But most of times, it will only help to aggravate the problem because it strengthens and Child’s dislike for food. Try to make mealtimes pleasant. Since Jasmine is 10 month old, her diet should include “three or four servings of starchy foods, such as bread, pasta, potatoes or rice, a day .One serving of meat, fish, eggs, or two of pulses (lentils, peas, beans) or nut butters. One to two servings of cheese, fromage frais or yogurt as well as breast milk or formula milk.” It is always advisable not to provide a 10 month old child sugar, salt, honey and any other artificial sweeteners. Avoid giving tea to 10-month-old child as the caffeine it contains is not good for small child and the tannin in tea interferes with iron absorption. Try to avoid food which might cause food poisoning such as liver pate, soft mould ripened cheeses and raw or soft-boiled eggs. Infants are given solid foods at about six months old. From this time onwards until about 24 months old, a child will learn plenty about foods. But in case of Jasmine’s case, she has not weaned to solids foods yet. It is, probably one of the reasons for her under weight. In the past four decides, the number of overweight children has gone up drastically. The abundance of processed food, hurried life style and the lack of focus by parents are creating unhealthy children. Moreover, in the last two decades, food companies and restaurant have been increasing the amount of food, which is contained in a serving. Generally, a child eats more if the size of the portion on their plate is larger. 2-4 serving of each vegetables and fruits and 2-3 serving each of proteins (eggs, beans, fish and lean meat) and grains (brown rice, whole wheat bread, oat meat and pasta) are sufficient for a ten month old child. As the child has a small tummy and a fluctuating appetite, a ten-month-old child should be fed three to four mini meals in a day. “Each meal should include a fruit or a vegetable and you may want to vary proteins and grains throughout the day. Following the mini-meal concept, means that you need to pay just as much attention to offering well-balanced nutritious snacks as you do the traditional meals of breakfast, lunch and dinner.” (Tallman, & Ahlers, 2002). It is very important to pay attention to eating patterns of Jasmine, as the key to balanced diet is variety. Variety in foods provides nutrients. A child has to eat a variety of food in order to ensure that he is getting all of the nutrients to grow. Breast-feeding of the jasmine should continue for at least 12 months and after that as long as mutually desired. Generally, infants lesser than six months old, do not require variety of foods to secure nutrition. Human milk is sufficient to provide minerals, vitamins, fats, carbohydrates, and proteins required for normal growth and development. In some cases iron and vitamin D may be given before six months to some infants. Child weaned before 12 months, should not be given cows milk. He/ she should be provided with iron fortified infants formula. Jasmine should be introduced to supplemental foods. It is better to starts with single grain cereal. Gradually, other ingredient foods can be added to the diet till she takes a variety of foods. New variety of foods should be added at a gap of a few days. “Fluoride should not be administered to infants during the first 6 months after birth, whether they are breast- or formula-fed. During the period from 6 months to 3 years of age, infants require fluoride supplementation only if the water supply is severely deficient in fluoride (less than 0.3 ppm). (Barrett, Stephen). Generally, low- fat and cholesterol are recommended for an adult, they are not suitable for children. During infancy, nutritional requirements are higher. But the stomach capacity is limited. So food item should provide sufficient nutrients and calories in small volume. So small children need fat in their diet for normal growth and development. Generally, children who eat a variety of foods will get sufficient fiber for their needs. So Jasmine should not be provided a high fiber diet as it is very low in calories and can interfere with absorption of calcium, iron, zinc and magnesium. Jasmine requires sugars in moderation. Sugar is a source of calories and makes food tastier. But sugar is connected with tooth decay, but a proper feeding practices, good dental hygiene, and sufficient fluoride intake will decrease the possibility. Artificially sweetened foods should not be given to a young child as they lack the required calories. A ten-month-old child needs sodium in moderation. It also increases the palatability of some foods. Although a healthy child can endure a range of sodium intakes, moderation in sodium intake is always urged. Caring for Jasmin: Jasmine has been admitted to the hospital as she suffers from malnutrition. At hospitals, Jasmine calls to her parents saying “Dada or Mama”. She is likely to feed by herself at every meal. She tries to stand up but she understands that in order to stay steady, she has to hold on something she tries to explore everything. A nurse who takes care of jasmine should know that at this age a child is very curious and wants to try it out everything. She also has short attention spans and suddenly loses interest in one thing and move to something else. For instance, when the T.V is on, she likely to play with the controls or hit the screen. Asking her to stop is often futile. Because, T.V is very interesting to Jasmine. Jasmine can push or turn the controls, which are right size for her small fingers. Moreover, screen displays of colours and light and it creates noise too. Asking her not to touch TV does not work because she is just developing the memory. She may not be able remember that she is not allowed to touch T.V. when something else is shown, which is able to attract her attention, she suddenly moves towards the new object. A nurse who takes care of jasmine should know about the psychology of a 10- month old child to provide her good care. It is found out that many home products are poisonous. The following home products can be poisonous to Jasmine and make it sure, it is beyond her reach. Turpentine, lighter fluid, kerosene and charcoal lighter, rat poison, bug spray and ant poisons. Kitchen cleaners such as dishwasher detergent and oven cleaners, Products such as anti freeze and gasoline, beauty and bath products such as nail polish, make up and perfume General cleaners such as furniture polish, ammonia and polish, Medicines such as sleeping pills, aspirin, cough syrup and laxatives. If Jasmine or any other child swallows any of the above-mentioned home products, a nurse should get help immediately. At this stage, children are very curious by nature and try to crawl everywhere. They even try to climb to get things which they want. Keep all poisons products, out of her reach. Plants and flowers can add beauty to our surroundings. Many plants and flowers could be dangerous. It is observed that children aged around 10 months often want to play with plants. Some plants have poisons in their flowers, seeds or in leaf. Some plants have thrones, for instance, roses and cactus. Poisons ivy can produce a rash. So a nurse who takes care of Jasmine should be able to identify poisons plants and flowers. The house plants are should be put out of reach of Jasmine and she should not be allowed to put plants and flowers in her mouth. A nurse should remember that holiday plants such as holly, mistletoe, and poinsettia could be poisonous. A nurse should not make toys, whistles, garlands from unknown plants. In case, a child touches a poisonous plant, a nurse should remove all her clothes, her skin should be washed with soap and water and her clothes and shoe should be washed with hot water and soap. Incase the child develops a rash, a doctor should be called. A ten-month-old child requires proteins and iron for normal growth and development. This aspect of nutrition is very important since Jasmine is under weight. Foods like fish, poultry, pork, beef, and beans are all good sources of iron and protein which a 10-month-old child requires. While adding new food items to child’s diet, a nurse should watch out for allergic reactions. Do not include honey in the diet of Jasmine before she becomes one year. By the time the child approaches her first birthday he/she may eat less as his/her growth rate is slowing down. Instead of getting worried, a nurse should offer healthy food to Jasmine at set time. A nurse should hold the baby in her lap when she gives his/her a bottle of formula. Never allow the child to lie down while drinking. When the child want to get down, take the bottle away. A nurse should not allow a child to falling asleep with a bottle containing sugary liquids as it might leads to tooth decay. A ten-month-old child is aware of her surroundings and is afraid of a sudden siren, a stranger, or loud bark. When a child is in strange surroundings, a nurse should give comfort and reassurance and should give time to adjust with it. In a strange place, a nurse should hold the baby and allow her to look around and talk in a calm and soothing voice. At 10 months of age, babies may not be able to clean their own teeth. A child learns from watching others. A nurse should set an example by cleaning her own teeth after every meal. Let the baby see you doing it. Then, using a neat wash cloth, clean baby’s teeth. Try to make teeth cleaning a fun. Games for skill building A good nurse should train his ward to develop social skills. Physical skills: - a young child loves to initiate people. Sit with a child on the floor and allow her copy your physical activities. For instance, hit on an empty box with a wooden stick. Give the stick to child and let her repeat. Emotional skills: - A nurse can develop emotional skills in Jasmine by making her pride in what she does. Tell her often that she is growing strong. Tell her that she is kind and smart. For instance, when Jasmine moves towards telephone when its rings. A nurse should say, “Wow, what a wonderful girl you are; you know when a phone rings. Intellectual skills: - a nurse can help Jasmine to develop his/her intellectual skills. For example, give the child two or three empty boxes. Talk about smallest, biggest, widest, tallest, shortest, or longest box. Social skills: - A nurse can teach a child several social skills. For example, she can teach the child to touch gently. When a child grabs her hair, she can tell her/his in a calm voice. “Jasmine, it hurts me, you hold your hand like this and touch my gently.” When the nurse says this, she should hold Jasmine’s hands open. Language skill: - a nurse should play lots of echo games. Make sounds like ba, ba, ba, or la, la, la. Encourage the child to repeat the sound. If the child makes sound, echo her. This will make her ready for saying real words. A nurse should encourage a ten-month-old child to choose a lovey. Loveys are security comfort objects, which offer security and comfort to child. Loveys can be a stuffed toy, blanket, or silky rag. Loveys help the child to learn about being apart from his dear or near ones. It can help the child to find comfort anywhere. Whenever a child is upset or needs comfort offer the same object. Some other safety measures for a 10-month-old child Remain with a baby when he or she is playing with water. Nurse should never leave the baby alone in a pool or bath. No one should shake a baby. Small babies have big heads and feeble neck muscles. Their brain tissues very weak and sudden movement can harm brain cells. Always keep the child away from things, which could harm her. Always put the child sleep on her back. Always serve healthy foods. Avoid salty, sweetened, or fatty ones. By nature, a ten-month-old child is very curious and wants to explore everything. This can put her in to trouble. She wants to touch, taste, and hold everything even delicate and dangerous. A good nurse should set limits for her ward. Works Cited Infant Growth and Development. (2006). Anatomy and Physiology. Retrieved June 20, 2007, from http://www.bookrags.com/research/infant-growth-and-development-wap/ Your Child’s Growth. (2007). Kids Health. Nemours Foundation. Retrieved June 20, 2007, from http://www.kidshealth.org/parent/growth/growing/childs_growth.html Making Baby Food for Your 10-12 Month Baby. (2005). Homemade Baby Food Recipes. Retrieved June 20, 2007, from http://www.homemade-baby-food-recipes.com/making-baby-food.html Malnutrition. (June 30, 2006). Medicine. REST. Retrieved June 20, 2007, from http://www.emedicine.com/PED/topic1360.htm Diet and Nutrition. (2005). Doctor NDTV. Retrieved June 20, 2007, from http://www.doctorndtv.com/Children/detailtopics.asp?id=10 Balanced Diets – for Quick & Healthy Weight Loss. (2007). Buzzle.com. Retrieved June 20, 2007, from http://www.buzzle.com/articles/balanced-diets-quick-healthy-weight-loss.html Micronutrients. (2007). Canada. Retrieved June 20, 2007, from http://www.acdi-cida.gc.ca/CIDAWEB/acdicida.nsf/En/FRA-4422402-563 Tallman, Cheryl., & Ahlers, Joan. (2002). Fresh Baby LLC. Dietary Essential for Your 12-24 Month Old. Retrieved June 20, 2007, from http://freshbaby.com/healthy_eating/healthyeating_featured_11.cfm Barrett, Stephen. M.D. Dietary Guidelines for Infants. Retrieved June 20, 2007, from http://www.quackwatch.org/03HealthPromotion/dgi.html Read More