In: Nursing
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.