NAME______

N331- Case Study #6: Adolescence

Case Study: Adolescent Pregnancy

Two adolescent females in the same grade become pregnant. One is 16.5 years of age: her menses began at age 14, and her weight for height is below the 5th percentile. The other pregnant adolescent is 15 years of age: her menses began at age 9, and her weight for height is at the 50th percentile.

  1. Describe the theoretical difference in nutritional needs of the two adolescents.
  1. Which one should be given clinical priority? Why?
  1. If neither young woman sought prenatal care, what might you expect as the outcome for the respective infants? Why?

Case Study: Fatigue; Poor school performance

Ellie, 15, is not doing well in school. Her teachers notice she is not concentrating in class. At home, her parents find her sleeping instead of doing her homework. She is irritable to her family; she never wants to do anything with them any more and complains that she is too tired.

At a health checkup the following screening information was obtained. Ellie is 63 in (160 cm) tall, without shoes, and weighs 108 lb. (49 kg) in light indoor clothing. Blood test results were hemoglobin= 10 g/dl; hematocrit= 30%. Ellie started her menses at age 12; her monthly period lasts about one week, with heavy flow the first three days. Ellie’s eating habits are erratic and she is afraid of “getting fat." A typical day's food intake is:

Breakfast:Cold cereal with sliced banana; Skim milk

Lunch:Eats school lunch depending on the menu. Her favorite meals are pizza, spaghetti with tomato sauce, and grilled cheese sandwiches. On other days, she just eats the foods she likes usually the salad and applesauce or peaches. Sometimes she drinks all the milk, but usually about half.

After school:Low-fat cookies; Low-calorie soda

Dinner:Poultry, fish, or pasta; Green vegetable, like peas

Salad with low-calorie dressing

Low-fat cake; Skim milk

Evening snack:Pretzels; Low-calorie soda

  1. Using the attached growth chart, plot Ellie’s height and weight. What is the comparison between her height and weight? What other information would be helpful?
  1. What are the normal levels for hemoglobin and hematocrit? What is your interpretation?
  1. What are some reasons that teenage girls are especially at risk for iron-deficiency anemia? What factors apply to Ellie?
  1. Why is fatigue a common symptom of anemia? What are other possible causes of Ellie’s symptoms that might be misleading?
  1. An iron supplement, ferrous sulfite, was prescribed for Ellie. Could a high-iron diet achieve the same results? What are the two types of iron available in foods? Name some foods that could contribute iron to Ellie's diet. Are there any combinations of foods that would help Ellie? Explain.
  1. Some of the foods in Ellie’s current diet are good sources of minerals other than iron. What are they? What other minerals might be low in Ellie’s overall diet? What are some potential short-term or long-term effects? How would you counsel Ellie?