Question

haleen: 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:

5) 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?

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

Answer 1

CONCERNS AND RECOMMENDATION FOR ALCOHOL INTAKE IN PREGNANCY:-

• Alcohol should be avoided during pregnancy as it leads to genetic disorders or neural tube defects in the new born.
• When pregnant women drinks alcohol it passes to her blood then through circulation goes into foetal blood, which in turn reduces the cell growth of the foetus hence also results in growth retardation. Sometimes it leads to miscarriage at early stages of pregnancy.
• Heavy alcohol consumption leads to still birth or premature birth of baby. After delivery the new born shows the symptoms of withdrawl as now baby is not getting amount of alcohol in his blood after delivery, so many newborns show withdrawl symptoms.

Thus, alcohol should be avoided during pregnancy to prevent your baby from its harmful effects. Parents should also take help from the community health services regarding this. Counsellig of mother should be done to make her aware of the harmfull alcohol effects.

Best Ensure Adequate Nutrition for Newborn:- The nutrition diet of newborn depends on the diet that mother takes, so it is the foremost duty of a mother to maintain her nutrition during pregnancy.

• Total calorie intake should be 2500 Kcalorie per day but you have to make sure that the diet is balanced between diabetic and hypertensive diet.
• As the Shaleen has history of now heperglycemia and hypertension so she should have to avoid extra sugar and salt in the diet.
• Make sure that you take small and frequent meal diet so as to maintain blood glucose level and blood pressure.
• Light exercise or morning walk is useful in order to balance the blood glucose level for whole day.
• Instruct the mother to increase vitamins, iron and folic acid in her diet to prevent baby from genetic disorders.
• Consult with community health providers in case you find problem in stopping your habbit of alcohol.
• Routine follow up with physician should be done to assess the regular growth of foetus.