Question

1,) J.W. is a 25-year old female. She is currently pregnant in her first trimester and has been suffering from hyperemesis gravidarum. Because of this, she is struggling to stay hydrated and nourished. She is 5’4” and her pre-pregnancy weight was 155 lb. Now, at 10 weeks pregnant, she is 138 lb. Her Obstetrician is very concern and refers her to you for nutrition advice. What are you recommendations?
Key topics to cover: % weight loss, % UBW, risk of malnutrition, nutrition management of hyperemesis gravidarum, calorie and protein target, ideal weight gain throughout remainder of pregnancy. Please be specific.

2.)  Three weeks after your visit with J.W., she is continuing to lose weight and still struggling to keep any food down. Her weight is now 135 lb. Her Obstetrician feels she would really benefit from tube feedings. He has selected the tube feeding formula Osmolite 1.0 (which is 1 kcal/mL tube feeding formula). Describe the tube feeding regimen you would recommend.
Key topics to cover type of tube, type of infusion (continuous, intermittent, bolus), daily kcal needed, goal rate of tube feeding, clinical outcomes to monitor.

3.) With much credit to your nutrition recommendations, J.W. had a safe and healthy pregnancy and delivered a healthy baby girl, G.W. Fast-forward 5 years later and J.W. is at the Pediatrician’s office because she is concerned that G.W. is a very picky eater. She is worried that G.W. is underweight because of her picky eating. She is 30 lb, 40 inches. Plot her weight-for-age, stature-for-age, and BMI-for-age (see attached) on each growth curve. Describe your findings.
Key topics to cover: What is G.W.’s percentile for each growth curve? Is she underweight, normal weight, overweight, obese? About how many calories does she need? What are some general nutrition tips you have for J.W. and G.W.?

PLEASE ANS ALL THE SUB-QUESTIONS.

Answer 1