TamaraDezSahagian

WestCoastUniversity
November10,2014
CaseStudy#1
Annabelle K. is a 15-year-old high school student. She comes to the medical clinical for a
school-related physical examination. When she walks into the examination room, you
note that she has a very thin appearance. She tells you, Ive been on a diet. Now I can
become a model like Ive always dreamed. What do you think? Im going to be the next
big super model! When you ask her about her daily food intake, she tells you, I dont
eat a lot. I need to keep my weight down so I can model. I usually have a diet soda in the
morning thats my morning caffeine then an apple or small salad no dressing -- for
lunch, then whatever my Mom makes for dinner but only half a portion. When you ask
her about her normal daily activities, she tells you, I go to my classes in the morning,
then I have modeling lessons in the afternoon. I do my homework at night or watch TV or
practice modeling. During your examination, you note that her hair and skin are dry and
that she has slight edema of her ankles. She has weak muscle strength and a weak hand
grasp.
ApplyingCriticalThinkingtotheCaseStudy:
General
1. What is your initial impression? Why?
My initial impression of Annabelle is that she is malnourished because her appearance
her dry skin and hair, the edema in her ankles, her weak muscle strength and weak hand
graspexhibits results of a poor diet.

2. What laboratory tests should be ordered? Why?

Laboratory tests that should be ordered are a Complete Blood Count
(CBC), fluid and electrolytes, Albumin and Proalbumin as well as a
blood glucose check. The CBC will show us if she is anemic; because
she has edema and brittle hair that indicates her electrolytes are off
balance therefore the fluid and electrolytes test is needed; her diet is
also poor and lacks protein as well as weak muscle strength shows
signs of insufficient protein intake, therefore there is a need to order a
Proalbumin or albumin test to confirm this.
3. What are the keys to achieving optimal nutritional status for Annabelle?

The keys to achieving optimal nutritional status for Annabelle are maintaining an
adequate nutritional diet; this ensures that she is eating enough of each food group. To
help achieve this, a plan for her needs to be made and she needs to be educated on how
important it is to eat healthy.

4. How would you respond to her? How would you motivate her to follow your
recommendations?
I know that she wants to be a model therefore I would relate everything I say to her
achieving her goal. For example, I would educate her on eating enough of every food
group so that she can obtain enough energy to stand for long periods of time so she can
model. She can still maintain her ideal weight with the right foods and exercise.

5. Formulate a meal plan for an adolescent, include caloric requirement, and identify each
food category.
Caloric requirement: 2200 calories
Breakfast:
Oatmeal 1 cup
Coffee 1 cup
Orange juice cup
Banana 1 medium sized
Snacks: 1 Pear, 4 Graham crackers with Peanut butter (2-3 Tbsp.)
Lunch:
Tuna Sandwich 1 serving
Small sized Apple
Diet Soda 12 oz.
Snacks: Almond bar with 1 cup of 2% milk
Dinner:
Tomato spinach chicken breasts 1 serving
Mashed potatoes 1 serving

Steamed Vegetables 1 cup

Orange Juice cup
Snacks: Nonfat chocolate pudding with 1 cup of 2% milk