Therapeutics - Pediatrics: Nutrition 1

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kyleannkelsey
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293526
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Therapeutics - Pediatrics: Nutrition 1
Updated:
2015-01-21 20:48:53
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Therapeutics Pediatrics
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Therapeutics - Pediatrics:
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  1. What is the dose of MVI for pediatrics?
    • <2.5 kg = 2mL/kg
    • >2.5 kg = 5 mL
    • > or = to 11 yrs = 10 mL
  2. How does pediatric MVI differ from adult?
    • No propylene glycol
    • More fat soluble vitamins = ADEK
  3. If a patient over = to or > 11 years is receive TPN for > 2 weeks, what supplementation is required in addition to MVI?
    Vitamin K
  4. What is the significance of adding additional Cysteine to pediatric TPNs?
    • Conditionally essential AA
    • Acidifies the bag, increasing the amount of Ca and phosphorus that can be dissolved
  5. What are the common complications of TPN in pediatrics?
    • Cholestasis
    • Osteoporosis
    • Line complications
  6. When is Cholestasis expected to arise after commencement of TPN?
    2 weeks to 2 months
  7. What lab values indicate Cholestasis?
    Gtt and direct bilirubin increases, followed by Increased AST and ALT
  8. What are the treatments for pediatric TPN induced Cholestasis?
    • Cycling of TPN
    • Withdrawal of TPN
    • Enteral feeding
    • Ursodial (Actigall)
    • Cholestyramine (Questran)
    • Phenobarbitol
  9. What is the brand name for Ursodial?
    Actigall
  10. What is the generic name for Actigall?
    Ursodial
  11. What is the generic name for Questran?
    Cholestyramine
  12. What is the brand name for Cholestyramine?
    Questran
  13. How is TPN induced osteopenia treated in pediatrics?
    Give as much Ca, Phosphorus and Vitamin D as possible
  14. Why is enteral nutrition better than parenteral?
    • Maintains GI functional and structural integrity
    • Decreased bacterial translocation
    • Enhanced utilization of nutrients
    • Ease and safety of administration
    • Decreased hepatobilirary complications
    • Less expensive
  15. What are the contracindications to enteral feeding?
    • Necrotizing enterocolitis (infected bowel)
    • GI obstruction
    • Intestinal atresia
    • Severe inflammatory bowel disease
    • Acute pancreatitis
  16. What diseases are reduced when infants are breastfed?
    • Crohn’s disease
    • Diabetes mellitus
    • Eczema
    • Asthma
    • Allergic gastroenteritis
    • (all autoimmune diseases)
  17. What are the CI to breastfeeding?
    • CMV
    • Herpes or Syphilitic lesions
    • Chicken pox
    • TB
    • Pertussis
    • Hep B
    • HIV
    • Intolerance
    • Some meds
    • Prematurity (< or = to 34 weeks)
  18. What are the preterm formulas and how do they differ from normal formulas?
    • Similac Special care and Enfamil premature formula
    • More protein, more calorically dense (20-24 kcal/oz) and more Ca and Phosphorus
  19. What are the transitional formulas?
    • Help transition preterm babies to term milk:
    • Neosure and Enfacare
  20. What must a preterm infant receive if they are getting formula?
    Supplemental iron
  21. What formulas are partially hydrolyzed?
    • Similac Sensitive
    • Enfamil Gentlease
    • Similac Total comfort
  22. What formulas are soy based?
    Prosobee and Isomil
  23. What are the indications for Soy based formulas?
    • Lactose intolerance
    • Cow’s milk allergy
    • Galatosemia
    • Lactase deficiency
  24. When would a partially hydrolyzed formula be indicated?
    • Lots of spit up = potential protein allergy
    • Colicy
    • Refluxy
  25. What are the Casein hydrosylate based formulas used?
    • When all other formulas are not tolerated
    • Severe persistant GI disruption or diarrhea
  26. What are the Casein hydrosylate formulas?
    • Alimentum
    • Nutramigen
    • Pregestimil
  27. What are the elemental formulas?
    • EleCare
    • Neocate
    • Puramino
  28. What are Advance or Lipil formulas?
    Contain extra FFAs associated with increased visual acuity (DHA and ARA)
  29. What formulas are available for older children (for ages 1-10 years)?
    Kindercal and Pediasure
  30. What are the complications of formulas?
    • Vomiting
    • Diarrhea
    • Constipation
    • Dehydration
  31. What are the daily caloric need of an infant?
    100-120 kcal/kg/day
  32. What are the daily fluid needs of an infant?
    140-160 mL/kg/day

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