Lucy is a 4-month—old female with no significant medical history, seen by you for the first time for poor growth.

2:17 PM Sun Nov 6 Done [:3 q + Automatic Zoom v View as Text ‘1, 1 of2 — Assignment 12: "Nutrition in Cystic Fibrosis" Case Study Lucy is a 4-month—old female with no significant medical history, seen by you for the first time for poor growth. Lucy was breastfed exclusively until 4 months of age and then maintained on a combination of breast milk and infant formula. Her parents report that Lucy is very eager to feed and appears interested; however, she fails to gain weight. They notice that she sweats a significant amount. They are also concerned with her increasing stool pattern, which is foul smelling and appears greasy. Mom and Dad both work. Lucy has an older brother age 3 years. They have support from extended family. Lucy’s grandmother takes care of Lucy and is also present for the visit. Lucy’s grandmother mentions that when she kisses Lucy, she has a salty taste to her skin. Anthropometrics: Length 59.5 cm (23.4) Weight 5.0 kg (11 lbs) Weight History .)) Download Age (months) Weight kg (lbs) Length cm (in) Birth ( 0 month) 3.4 (7) 52 (20.5) 1 month 4 (8.8) 55 (21.7) 2 months 4.8 (10.6) 57 (22.4) 3 months 5.0 (11) 58 (22.8) Biochemical Data: Sodium 123 (135-145 mEq/L) Potassium 2.9 (3.6—5.0 mEq/L) Chloride 73 (98-110 mEq/L) Carbon dioxide 22 (20-30 mEq/L) Clinical Data: Past Medical History: None Medications: None Vitals Signs: Normal Nutrition-focused Physical Exams: Lucy is alert but appears distressed. When you observe her, she has a productive cough during the visit. Questions Blood urea nitrogen 25 (6-24 mg/dL) Creatinine 1.8 (0.4—1.3 mg/dL) Glucose 78 (70-139 mg/dL) 1. Use wwwpeditoolsorg to calculate the percentiles for each month of this patient. Use the WHO Growth Standard for 0 to 24 months to calculate these percentiles. Use the Wt %ile for this assessment. (4 points) 38% >>

2:17 PM Sun Nov 6 Done ED q Age (months) Weight kg (lbs) Length cm (in) Weight %ile Birth 3.4 (7) | 52 (20.5) 1 month 4 (8.8) 55 (21.7) 2 months 4.8 (10.6) 57 (22.4) 3 months 5.0 (11) | 58 (22.8) 2. How would you assess her nutritional status based on the growth percentiles calculated above? (3 points) 3. How would you assess her lab values? Are the elevated, low, within normal limit? What do these values indicate for this patient? (3 points) Case Study REVISITED Following Lucy’s diagnosis of CF, you are asked to provide energy and protein goals for Lucy. 4. What factors should be considered in determining energy and protein requirements? (2 points) 5. What are Lucy’s nutritional risk factors? What nutritional indices will you monitor routinely? What goals will you set for this patient? (4 points) 6. In addition, suggestions for micronutrient supplementation are requested. Provide your recommendations with appropriate rationale. ( 4 points) ‘5″ 37% ‘1’ 2 of 2 — + Automatic Zoom v View as Text Download >>