Assignment
Ryan is a 6-year-old elementary school student. At his last well-child exam, his height was 46 inches and his weight was 56 pounds. His pediatrician is concerned that Ryan has gained an excessive amount of weight over the past year. His usual diet consists of sweetened cereal with whole milk and fruit juice for breakfast and a juice drink and crackers for his midmorning snack. During the week, Ryan buys his lunch at school; his favorite menu items are pizza and tacos. His parents give him money in case he wants to buy some additional à la carte food items from the cafeteria. His mother states that she started a new job this past year and is going to school 2 nights a week, which requires that Ryan attend an after-school program until 5:30 or 6 in the evening. He receives a snack there, usually an 8-ounce box of fruit juice and crackers. Ryan's parents report that Ryan is "always hungry" and that they will often stop for his favorite chicken nuggets, fries, and a soda on late evenings when the family is too tired to cook. Ryan likes to play video games and has a computer and television in his room. His father reports that Ryan spends more time in his room than playing outside. Ryan's mother is overweight and his father is of normal weight, although he states he was overweight as a child. The family has discussed getting more exercise on the weekends but are not sure how to add this to their busy schedules.
• Describe what you observed are health behaviors of Ryan's that could be modified to improve his health.
• Explain two achievable steps Ryan and his parents could take in improving his health today for lifelong wellness.
Roy is an 89-year-old African American man. He is a retired pastor who was married for 60 years before the death of his wife 6 months ago. He now lives alone, close to his daughter and her family, in a high rise for low-income elderly individuals. Roy recently stopped driving on the advice of his physician and depends on his daughter and grandchildren to help him with groceries and to transport him to medical appointments. Although in reasonably good health, he has lost weight over the past year and reports feeling more tired than usual and having repeated colds. Since his wife's death, he has stopped going to his exercise class and prefers to eat his meals in his apartment rather than in the community dining facility. He prepares his own meals, which usually include toast and coffee for breakfast, a meat or cheese sandwich with potato chips and milk for lunch, and canned soup or chili beans for dinner. He rarely eats between meals. Although usually at a healthy weight for his height, Roy's family is concerned about his weight loss of 12 pounds since his wife's death. They also express concern about a recent fall he had that resulted in a number of bruises on his body.
• Summarize the nine D's of geriatric weight loss" dementia, drugs, dysphagia, dysgeusia, dentation, diarrhea, depression, disease, and dysfunction.
• Consider Roy's challenges with weight loss and describe which of the nine D's of geriatric weight loss are impacting his life.
• Explain two achievable steps Roy and his family could take in improving his eating habits today with the goal of weight loss prevention.
Iron and Folate:
• Describe iron and folate needs during pregnancy.
• Explain whether you think consuming the RDA for iron and folate during pregnancy is attainable through food sources only or if supplementation may be necessary. Explain your reasoning.