Flashcards in Pediatric Oncology Nutritional Management-Chapter 15 Deck (18):
What are the most common Childhood
Brain and spinal cord
Hodgkin's and Non-Hodgkin's lymphoma
Bone cancers including
osteosarcoma and Ewing's sarcoma
Because of research in consistencies, usual energy needs per age of children should be assumed, suggesting that the____maybe the MOST APPROPRIATE TOOL for estimating energy needs in NORMAL-WEIGHT children with cancer
or Dietary Reference Intakes for estimated energy requirements (EER) for children
For children and adolescents less than 20 years of age__________are used to diagnose overweight and obesity
BMI-for-age growth charts
When possible, energy requirements of obese pediatric patients should be accessed via indirect calorimetry
Body mass index should be used to screen children for obesity
BMI for age at or above gender-specific_____percentile reflects obesity.
A BMI between the_____and the_______percentile reflects an overweight status.
85th and 95th percentile.
What type of Childhood Cancer is it common to find obesity in the children, particularly in those who have received cranial irradiation?
Survivors of ALL
Are the energy needs of children with cancer greater or less than children without cancer?
The needs of children with cancer may be greater, lower, or similar to the needs of healthy children.
What are the four ways that CATCH UP GROWTH is evaluated in children with cancer?
Weight for stature below 5th percentile on the WHO or CDC clinical growth charts
Weight or height deficit of more than 2 percentiles from usual percentile channel on the WHO or CDC growth charts
Weight for length less then 5th percentile or less than 80% of IBW for height per the WHO growth charts
Body mass index less then 5th percentile on the CDC growth charts
The children's oncology group reports that cancer treatment may increase protein needs by what percentage?
Albumin and pre-albumin may not always give adequate indications of protein stores what maybe it better an alternate tool to indicate protein status and adequacy of protein intake in children?
Nitrogen balance studies
What is the best method for estimating fluid needs and children with cancer?
Holliday Segar method:
1-10 kg. ....100mL x kg
11-20 kg...1000mL for 1st 10kg+50mL/kg/day per kg for each 11-20kg
Over 20 kg...1500mL for 1st 20kg+20mL/kg/day for each kg over 20
What is the PROTEIN intake recommendation for boys and girls with cancer?
Age. Protein intake needed (g/kg/day)
1-3 y. 1.05
Children with which type of pediatric cancers are at the highest nutritional risk
Wilms tumors (stages lll & V, unfavorable history and relapsed disease)
Neuroblastoma (stage 3 & 4)
Metastatic solid tumors
Non-hodgkin lymphoma (stages 3 & 4 and relapsed)
Acute & Chronic Myelogenous leukemias (new & relapsed)
Medulloblastoma and other brain tumors
Pediatric cancers with the lowest nutritional risk
Acute lymphocytic leukemia with good prognosis
Non-metastatic solid tumors
Advanced diseases in remission during maintenance treatment
A suggested criteria of monitoring the degree of malnutrition in children is to use the anthropometry in relation to reference curves using Z SCORES.
What Z scores indicate mild, moderate and severe malnutrition?
Mild malnutrition (z score
One way to evaluate children for nutritional risk is to use anthropometric measurements. An important part of this is to valuate growth. What are the best ways to evaluate growth in children?
Use BMI standards to assess weight
Use 2006 WHO charts to assess and track growth of children up to 2 years of age, and this should be measured in the Supine position for LENGTH
Children ages 2 years old to 20 years old should be evaluated using the 2000 CDC charts to assess and track growth measured via standing HEIGHT
Finally, use Z scores and consider a decrease of more than one Z score problematic
What are the daily vitamin D requirements for children between the ages of one month and 18 years?
1 months to 12 months. 400 IU
1 to 13 years. 600 IU
14 to 18 years. 600 IU