Jordan is a 14 year old middle school student, weighing 275 pounds and is 5’6” t
ID: 89147 • Letter: J
Question
Jordan is a 14 year old middle school student, weighing 275 pounds and is 5’6” tall. Over the past 2 years, he has gained 60 pounds, as he has begun to withdraw from social activities, and avoid other students, due to bullying from others his age about his weight/appearance. Lately, Jordan has been missing a great deal of school too, particularly on the days he has gym. Jordan’s parents are both average in height and weight, and Jordan’s mother says that he just takes after his grandfather William, who “was a husky man, and died of a sudden heart attack at the age of 44”. She says “We just have fat genes in the family; you can’t do anything about that”!
He has been told he had “no willpower, or is weak, or that he needed to change his lifestyle, eat less and exercise more.” Jordan says “I go for a couple days without eating, but then I get so hungry that I could eat the couch”!
Jordan has recently been diagnosed with gallbladder disease and has symptoms that typically occur after eating that include mild pain in the midepigastric region, radiating to the right upper quadrant of the abdomen and right subscapular area of the body.
You are the nurse assigned to Jordan.
What would you include in your initial assessment data based on the scenario provided?
What would you teach Jordan based on the RDA Recommended Daily Allowance from the choosemyplate.gov link discussed in lesson 1, and the information provided about gallbladder disease provided in lesson 6?
Based on your assessment data and the information from the scenario what might be two high priority Nursing Diagnosis to guide Jordan’s plan of care?
Explanation / Answer
Jordan should be advised how to balance his calories intake and manage his weight. On the basis of RDA he should be advised:
To reduce overweight by improved eating and physical cativity behaviors
Control total calorie intake to manage body weight
Reduce time spent in sedentary behaviours
He should be advised on the food components to be reduced from the diet:
Daily sodium uptake tobe reduced upto 1500 mg
Replace calorie intake from saturated fatty acids with monounsaturated and polyunsaturated fatty acids.
Consume less than 300 mg of dietary cholesterol per day.
Limit the intake of food with synthetic sources of trans fats.
Reduce the intake of foods that contain refined grains especially containing added sugars and sodium.
He should be advised on the food components to be increased in the diet:
Fruits and vegetablesespecially dark green and red and orange vegetables and beans and peas
Consume more whole grains than refined grains
Increase fat free milk products like yogurt, cheese, soy beverages
Increase the intake of protein foods such as sea food, lean meat, soy products
Recommended Dietary Allowance (RDA)- It is a dietary recommendation on the amount of a nutrient to meet the ntritional needs of practically all healthy persons.
Recommendations from ChooseMyPlate paln illustrates ten categories-
1. Balance Calories- To find out how many calories a mperson needs daily and plan the diet accordingly
2. Enjoy Your Food, But Eat Less- Take time to fully enjoy the food while eating.
3. Avoid Oversized Meals- To protion out foods before eating. While eating choose a smaller size option.
4. Foods to Eat More Often- One should eat more vegetables, fruits wnd whole grains
5. Make Half Your Plate Fruits and Vegetables- To use red, orange and dark-green vegetables like tomatoes, sweet potatoes and broccoli.
6. Switch to Fat-Free or Low-Fat (1%) Milk- This milk have same amount of calcium but fewer calories and less saturate fats
7. Make Half Your Grains Whole Grains – To eat more more whole grain product
8. Foods to eat Less Often- Avoid foos high in solid fats, added sugars and salt
9. Compare Sodium in Foods- To use lower sodium version of foods while selecting the canned foods
10. Drink Water Instead of Sugary Drinks- To reduce calories by drinking water.
Two high priority Nursing diagnoses in case of Jordan are:
1. Imbalanced Nutrition- Assessment will include diet history, height and weight, nutritional status and skin fold measurements.
The rationale for assessing nutritional status is that the patients with gall bladder disease may have imbalance diet or vitamin deficiencies.
2. The second diagnosis will be risk of dehydration and electrolytes disturbances due to inflammation related to gallbladder disease.
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