2. Some causes of energy imbalance in the individual include individual factors, family factors and community factors. Individual factors like her habits and personality may cause energy imbalance. The patient is a shy person, therefore, she is not as active as other children her age. This encourages laxity and eventually energy imbalance. Her eating habits are also a cause of energy imbalance. She relies on junk food which is high in calorie content and she doesn’t exercise much this is the cause of energy imbalance since she consumes a lot but does not spend that energy. Another cause is the amount of time she spends watching television. The patient spends four to six hours every day watching television and this contributes to energy imbalance. Family factors like genetic factors also influence this. The mother of the patient is also obese and this makes the patient predisposed to obesity. The patients grandma makes her come inside after playing for a short while in order for her to do her homework. This limits her playtime and causes energy imbalance. Her family also allows her to spend a lot of time watching television that causes the energy imbalance. Community factors also play a role in energy imbalance. The patient may have a limited friendship circle and this may be why she prefers to watch television instead of playing. Another reason may be that she is often teased by other children her age and, therefore prefers to stay indoors. All the above reasons have a big role to play in the patient’s condition.
3. One of the principles is following the correct recommended dietary allowances. This includes watching the calories that the child is consuming on a daily basis. This is important because one is able to regulate the energy intake of the child. Another aspect of weight management in children involves the types of food the child feeds on. That is the dietary composition of the meals. Some foods provide more energy than others do. The child should be fed with low energy foods in order to maintain their weight
4. The most important principle is the energy expenditure of the child. This is important because it gives a guideline on how to manage the weight of the child. If the child is an active child who takes part in sport often, managing his or her weight will be relatively easier. This is because one is certain that all or most of the energy consumed will be used during sport. This means that there will be little or none left to be stored in the body of the child as cholesterol so they will not gain weight. For an inactive child, their energy expenditure will be significantly lower. His means that more conversion and storage will occur and the child will be subject to sudden weight increases.
5. A PES statement has three parts, the problem or diagnosis, etiology and signs and symptoms of the patient. This statement acts as a summary of the medical history of the patient in question. In this case study, the following is an example of the PES statement.
Overweight and asthma, high blood pressure (107/57)/ shortness of breath during exercise, frequent consumption of fast food, physical inactivity, presence of genetic obesity trait/ BMI is 27 and is in the 80 percentile.
Problem: Overweight and asthma
Etiology: high blood pressure (107/57)/ shortness of breath during exercise, frequent consumption of fast food,
Signs: Physical inactivity, presence of genetic obesity trait/ BMI is 27 and is in the 80 percentile.
6. The first recommendation would be to watch her diet. They should take foods low in cholesterol and calorie content. Consumption of foods with lower calorie content will minimize their conversion and storage. She should stop taking second helpings of food especially during supper since the metabolism of the body slows down at night. This means that she will end up storing most of the food she had. She should also stop consuming juices instead of water when thirsty. This is because they do not serve the same purpose as water and in addition, they increase her calorie intake. She should take more water since it is required for most of the metabolic processes of the body. Another recommendation would be to cut down on the junk food that she consumes because it has no nutritional value. The final recommendation would be to become more active. This will help her burn the already accumulated calories. The time she spends watching television could be used to exercise or play.
7. In order to monitor her progress, one could schedule visits to her nutritionist monthly or every fortnight. During these visits, her cholesterol levels should be measured. This will prove if she has avoided junk food. Her weight should also measure in order to determine her progress. Her family and friends should help her by supporting her by not purchasing junk food in the house as well as exercising with her.
8. In order to achieve the goal of weight loss, the family may use community amenities. Sport centres and gym facilities may help the family to attain this goal. They can also use the parks for morning jogs. Such amenities will play a large role in helping the family.
9. Some factors may hinder the families’ compliance with healthy lifestyles. The cost of healthy foods is one such factor. Healthy foods such as fruits and whole grain cereals are quite costly. This may cause the family to revert to junk food as it is more affordable. This is proven by the fact that this family cannot buy enough fruit for the whole family. This is beyond their control because they may be willing to comply with healthy lifestyles but they cannot due to the associated costs.
10a. SOAP summary
Subjective: She was a shy active girl though a little overweight.
Objective: Her blood pressure was 107/75, heart rate normal. She was overweight and had shortness of breath.
Assessment: Her performance decreased in accuracy during the exercise session due to shortness of breath.
Plan: After considering, the information gathered during the session, exercise and healthy meals are recommended as treatment.
10b. ADIME summary
Skill area: Nutritional Therapy
Assignment Title: analysis of overweight child
What I learnt: Child has high blood pressure, shortness of breath during exercise (asthma).
Reflection to assignment: Child is otherwise normal, no conditions noted.
Recommendation: Child should exercise and avoid junk food.
Emery, E. Z. (2012). Clinical case studies for the nutrition care process. Burlington, MA: Jones & Bartlett Learning.