Reflective Questions

1. What additional assessment information would you collect?

To assess Ricky’s nutritional status and feeding difficulties, I would collect the following additional information:

• Dietary history: I would ask Ricky’s mother to record everything Ricky eats and drinks for 3-7 days. This would help me to identify any patterns in his eating habits and to assess whether he is getting enough nutrients.
• Growth chart: I would measure Ricky’s height and weight and plot them on a growth chart. This would help me to track his growth and development over time.
• Physical exam: I would perform a physical exam on Ricky to look for any signs of malnutrition, such as pale skin, brittle hair, or weight loss.
• Developmental assessment: I would perform a developmental assessment on Ricky to ensure that he is meeting developmental milestones.

2. What questions would you ask, and how would you further explore this issue with the mother?

To explore the issue of Ricky’s feeding difficulties with the mother, I would ask the following questions:

• When did Ricky’s feeding difficulties start?
• What foods does Ricky like and dislike?
• How does Ricky behave at mealtimes?
• What strategies has the mother tried to help Ricky eat better?
• What are the mother’s concerns about Ricky’s eating?

I would also ask the mother to describe her own feeding practices and her family’s approach to mealtimes. This would help me to understand the context in which Ricky’s feeding difficulties are occurring.

3. In what ways does the distance of the extended family influence this family’s approach to health promotion?

The distance of the extended family may influence this family’s approach to health promotion in the following ways:

• Lack of social support: Parents who live far away from their extended family may have less social support for parenting and childcare. This can make it more difficult to manage mealtimes and other aspects of health promotion.
• Cultural differences: Parents and extended family members may have different cultural beliefs and practices related to feeding and child rearing. This can lead to conflict and confusion for the child.
• Lack of role models: Children may benefit from seeing healthy eating habits modeled by their extended family members. If the extended family lives far away, children may have fewer opportunities to observe these healthy habits.

4. What factors would you consider to determine whether malnourishment is a factor in this family?

To determine whether malnutrition is a factor in this family, I would consider the following factors:

• Ricky’s dietary history: Is Ricky eating a variety of nutrient-rich foods? Is he getting enough calories and nutrients for his age and developmental stage?
• Ricky’s growth chart: Is Ricky growing and gaining weight at a normal rate?
• Ricky’s physical exam: Does Ricky show any signs of malnutrition?
• Ricky’s developmental assessment: Is Ricky meeting developmental milestones?

I would also consider the mother’s concerns about Ricky’s eating. If the mother is concerned that Ricky is not eating enough or that he is not growing properly, it is important to investigate these concerns further.

Conclusion

Ricky’s feeding difficulties are a complex issue that may be influenced by a variety of factors, including his age, developmental stage, family environment, and cultural background. It is important to conduct a thorough assessment to identify the underlying causes of Ricky’s feeding difficulties and to develop a plan to help him eat better.

Recommendations

Based on the information provided, I would recommend the following:

• Dietary counseling: Ricky’s mother would benefit from counseling from a registered dietitian to learn about healthy eating habits and how to help Ricky eat better.
• Feeding therapy: If Ricky’s feeding difficulties are severe, he may benefit from feeding therapy with a speech-language pathologist.
• Family support: Ricky’s mother would benefit from support from her extended family and other caregivers. This support could include help with meal preparation, childcare, and emotional support.

It is also important to address the root causes of Ricky’s frustration. This may involve working with Ricky’s parents to develop more effective parenting strategies or to address any underlying mental health issues.