Shaleen: Pregnancy & Lactation Case Study (10 pts.)

Shaleen: Pregnancy & Lactation Case Study (10 pts.) Instructions: This case study assignment should be treated as a short paper, including a cover page, a heading, and page numbers. Set up the paper with one-inch margins, double-spacing, with the font set at 12-point Times New Roman. The introduction to the paper should summarize the case you have chosen to discuss. Responses to the case study questions should be written in paragraph form. Each paragraph in the case study should begin with an introductory statement that lets the reader know what topic you will be addressing in the paragraph. For example, if the case study question asks, “What nutrients are deficient in Shaleen’s diet, based on her current diet history?” You might start the discussion in this paragraph by indicating: “Shaleen has X nutritional deficiencies, based on her diet history. Her current diet consists of XXXXX. She is deficient in XXXXX.” The paragraph would continue with the explanation (or rationale) for your response: “According to Rolfe et al. (2012), a 16-year-old requires XXXXX. Because she is pregnant, she also XXXXX and so on. Scenario: Shaleen is a 16-year-old inner-city youth and high school student. She requests a pregnancy test at the Public Health Clinic. The pregnancy test is positive and she informs the clinic that her last menstrual period was 8 weeks ago. Previous History: Shaleen has had two previous pregnancies, one a stillbirth in which she gained 15 pounds and the baby weighed 4 pounds at term. The other ended due to a miscarriage at 9 weeks gestation and occurred 6 months ago. Her first pregnancy was at the age of 13. Social History: Lives at home with her mother and 5 siblings. Her mother provides the only income as a third shift waitress at a local 24-hour restaurant. The family receives $200 per month in food stamps. You speak with Shaleen at the Public Health Clinic after she receives the positive results of her pregnancy test. A brief diet and health history indicates the following information. She is a three-year smoker and is constantly concerned about her weight. Her diet consists mainly of diet cola, pizza, burgers, hot dogs, and convenience pasta dishes like Spaghetti-Os. She does get school lunch for free because of her family income level but rarely eats the fruits and vegetables or drinks the milk. Since Shaleen is the eldest sibling, she prepares meals for her younger siblings and sometimes does not have time herself to eat what has been prepared. Physical Exam: Ht = 5’6” Usual Wt = 108 lbs. Present Wt = 110 lbs. BMI = BP = 118/76 Blood glucose = 100 Shaleen’s pregnancy progresses without any problems until at 30 weeks her physician becomes concerned because her blood pressure has risen to 140/95, her blood glucose is 180, and she has gained 7 lbs. in two weeks. She is showing signs of generalized edema and she has protein and ketones in her urine. Her weight at this time is 118 lbs. Questions:

1) Based on her current diet, identify 5 nutrients she is likely to be deficient in and why they are important during pregnancy.

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2) Suggest general changes Shaleen should have made in her diet at the start of her pregnancy. Use the MyPlate Food Guide as your reference.

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3) Evaluate her weight gain at 8 weeks and 30 weeks of gestation. What do her current weight gain pattern, blood glucose levels, and BP indicate? How much total weight should Shaleen have tried to gain with this pregnancy? What pattern of weight gain would you recommend for the remainder of the pregnancy?

4) Calculate her approximate caloric and protein needs at 30 weeks.

5) Using the MyPlate system as a basis, outline a diet regimen that Shaleen should follow to achieve the weight gain recommendations from #4 above.

6) As a teenager, Shaleen is probably exposed to the peer pressure of alcohol consumption. What types of concerns should you make Shaleen aware of with alcohol intake during pregnancy? What is the recommendation for alcohol intake during pregnancy for any woman?

7) How could Shaleen best ensure adequate nutrition for her newborn? What arguments would you use in favor of this method when consulting with Shaleen?

8) How would her caloric and nutrient needs change if she decided to breastfeed? What general dietary recommendations should be given to ensure that these nutrient changes are met?

9) If she decides to formula feed, how much should she offer and are there any cautionary points that she should be concerned about with this method of feeding? How does this food choice differ from breast milk?

10) At what point should her infant be introduced to solid foods? Outline a timeline for the introduction of these foods with appropriate suggestions for each new food.

 

In: Nursing

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