Nutrition: Foundations for Life

Best answer is "c".

Initially, counsel Mrs. Pequena about Becka’s diet. She is not making any severe nutritional mistakes, but a little bit less juice and milk may help increase Becka’s appetite for solid foods, which should be more prominent in her diet.   Suggest limiting milk to 20 oz and juice to 6 ounces, with access to water if additional liquids are desired. Children should be allowed specific eating times, rather than "grazing" (i.e. ad lib access to calories, especially juice). 

With this history of high milk intake and low food intake, Becka is at risk for iron-deficiency anemia, which may further depress her appetite.  A CBC is warranted. Although the house that Becka lives in was recently painted, the old paint was peeling and it is an “older” home.  Therefore, a lead level should be done.  Becka’s parents are both around the 25^th percentile for height -  a context which would imply that Becka’s height is normal for her. 

 Becka should be followed in the next several months to see if the suggested changes to Becka’s diet helped.  Careful attention should be paid to psychosocial and environmental parameters, but at this point a referral to CPS is not warranted.

ïBack

Forwardð