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Ch07 Summary The key concepts discussed in this chapter include dietary and nutritional guidelines throughout the life cycle, signs and symptoms of poor nutritional status, and clinical indicators of malnutrition (anthropometric measures and laboratory and diagnostic data). The two most common dietary guidelines are the recommended dietary allowances (RDA) and the USDA Food Guide. The RDA stipulates the recommended amounts of nutrients that a healthy individual should consume. These guidelines vary depending on an individual’s age, sex, and whether the person is pregnant or lactating. The USDA Food Guide and the DASH Eating Plan recommend that healthy individuals consume 7 to 8 servings/day from the bread, cereal, rice, and pasta group; 4 to 5 servings/day from the vegetable group; 4 to 5 servings/day from the fruit group; 2 to 3 servings/day from the milk/dairy group; and 4 to 5 servings/week from the meat and beans group. Additionally, individuals should limit their consumption of fats, oils, and sweets. Nutritional requirements change throughout the lifespan. Infants experience rapid growth and development during their first 12 months of life; thus their caloric and energy requirements are high. The American Academy of Pediatrics recommends the use of breast milk during this period of time. Iron-fortified cereals may be introduced when the infant is 4 to 6 months old, fruits and vegetables may be added when the infant is 5 to 8 months old, and finger foods may be introduced at 9 to 10 months. While physical growth may slow in toddlers, they continue to experience rapid development. Toddlers should be fed small portions, usually 1 to 2 tablespoons per year of age, and foods that they can feed themselves. Preschoolers enjoy small servings, food choice, and finger foods. School-age children experience erratic growth and eating patterns. They should be encouraged to consume a well-balanced diet and to limit highly sweetened snacks. Adolescents undergo periods of rapid growth and change, and thus have fluctuating nutritional needs. Because teens also develop an increased concern for body image, they may be at risk for eating disorders such as anorexia nervosa or bulimia. Caloric needs stabilize in young and middle-aged adults, whereas they decrease in older adults. Adults may be at nutritional risk for developing diseases such as obesity, osteoporosis, type 2 diabetes mellitus, and atherosclerosis. Caloric requirements will be determined by one’s activity level. Pregnant women are encouraged to consume an additional 300 calories per day and to drink six to eight glasses of fluid per day. Lactating women are encouraged to consume an additional 500 calories per day and 2 to 3 quarts of fluid daily. All women of childbearing age are encouraged to consume 0.4 mg/day of folic acid because scientific evidence suggests that folic acid supplementation may decrease the risk of neural tube defects in infants. Regardless of an individual’s age, a thorough nutritional assessment is essential. The nurse will obtain a nutritional history, anthropometric measurements, and laboratory and diagnostic data. The nurse will also assess for common signs of poor nutritional status such as fatigue, weight changes, changes in appetite, weakness, dry skin, cracked lips, swollen or bleeding gums, edema, and decreased muscle tone. The hematocrit, hemoglobin, cholesterol, triglyceride, transferrin, iron, total lymphocyte count, albumin, prealbumin, glucose, creatinine, and nitrogen values should be assessed, as abnormal findings may indicate nutritional alterations. Diagnostic data such as radiographic studies may also be obtained to identify nutritionally related diseases. Copyright © 2010 by Delmar/Cengage Learning. All rights reserved.