WELL-CHILD PROJECT

ABBY MILLER PART I I. Identifying data (1 point) A. Kambria (Kami) B. Healthy, pudgy, adorable 3-year-old with rosy skin, blond hair, and blue eyes. Healthy baby teeth. C. Middle class family with a stay at home mom and a lot of friend and sibling interaction. Health history (10 points) A. (1) Female (2) 3 years, 2 months (at time of interview) B. (1) Date of Birth: 09-29-2009 (2) 6 lbs 14 oz , between the 50th and 75th percentile range (3) 19 in, between the 25th and 50th percentile range C. (1) 35 lbs, at the 75th percentile (2) 37 in, between the 25th and 50th percentile range D. 4 siblings ages: 9 years,7 years, 5 years, and 8 months E. 35 lbs, 38 weeks, parity: 4th child F. No major illnesses, recently had strep throat and took antibiotics G. No current medications or fluoride treatments H. No dental carries I. No allergies or intollerances Developmental skills assessment (6 points) Summarize your findings from the DDST (refer to PowerPoint instructions on BYU Learning Suite): i. No opportunity : None Identified ii. Caution items: None Identified iii. Delayed items: None Identified iv. According to this screening Kami is normal. She is fully able to perform all motor, language, and social skills required for a 3 year old. Nutritional assessment (8 points) A. (1) Macronutrient Distributions: Carbohydrate: 52%; Fat: 34%; Protein: 15%; All of Kamis Macronutrient percentages were exactly on target for her age recommendations. B. (2) Grains: 5 oz; Vegetables: Less than 1/4 cup; Fruits: cup; Dairy: 1 cup; Protein: 2 ounces. Kami only met her requirements in the grain group. According to Kamis mother todays diet was less nutritious than normal. But during her 24 hour recall her vegetables were less than 1 cup and her fruit was only cup, far below her recommendation. Kami usually eats more fruits and vegetables during the day. Kami did pretty well with dairy, she had 1 cup, although there is no specific recommendation. Kami ate 2 ounces of protein which is 1 ounces short of her goal. C. (3) Kamis diet was low in fiber; she had 7 g when her target is 19. She was over in saturated fat by 1%, so there should be a slight reduction. Kami was only 45 mg under in calcium, so that should be watched for. More importantly Kami was low in potassium. She ate 1087mg, while her target was 3000 mg. Kami was also low in her fat soluble vitamins D, E. D. Kami is a great eater. She loves most food that is put in front of her, including vegetables. She loves tomatoes. E. At a typical family meal they sit at the table and eat a home-cooked meal as a family. F. No vitamins or supplements. G. No use of assistance programs. Nutritional care plan and implementation (15 points) A. The major concern in Kamis diet is the lack of fruits and vegetables. If Kami can increase her intake of whole fruits and vegetables she should be able to increase her fiber intake to an ideal range. Increasing fruits and vegetables would also increase Kamis potassium intake. Kami has high saturated fat, and low vitamin E. She should increase the amount of oils she consumes in place of saturated fat. Most of the saturated fat in Kamis diet came from crackers. Decreasing the amount of crackers in Kamis diet would

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be very helpful. Cheese, ice cream, and chicken nuggets also significantly contributed to saturated fat. Cheese is a great source of calcium for Kami, so I would probably limit chicken nuggets first and replace them with a less saturated protein source, such as baked or grilled chicken. Kamis diet was also low in the protein and dairy food groups. B. I will make three recommendations for Kamis caregiver. First I will recommend more fruits and vegetables throughout the day. Kami enjoys fruits and vegetables and will gladly eat them when they are offered. Although these foods are usually available at dinner, I will recommend them for snacks as well. I will recommend more tomatoes because they are kamis favorite and they are very healthy. I will also educate her caregiver on the importance of potassium. I will recommend increased fruits, such as bananas. The second recommendation I will give concerns the types of fat in Kamis diet. Kami is a child and high fat intake is recommended, however, Kami has too much saturated fat. I will explain the types of food in Kamis diet that are high in saturated fat (such as crackers and chicken nuggets) and suggest that these foods be limited, although not completely taken away. I will recommend the use of oils. For example, if Kami has vegetables as a snack she could dip them in an oil-based dressing. Finally Kami should try to increase the amount of protein and dairy in her diet by increasing the portions of these foods that she receives at meal times.