1-If Cherise were 17 years old, how would you classify Cherise’s blood pressure
ID: 81597 • Letter: 1
Question
1-If Cherise were 17 years old, how would you classify Cherise’s blood pressure based on the reading at the school nurses’ office?
2-What is Cherise’s weight classified as, based on the readings at the first visit at the community clinic?
3-What lab tests would you order (consistent with NHLBI recommendations)?
4-What dietary guidelines (CHILD 1) would you recommend for Cherise?
5-Why would Cherise want to increase her fiber intake?
6-What staged care treatment is recommended for Cherise when she visits the community clinic the first time?
7-Cherise has a younger 13 year old sister, what is the suggested health screening schedule for Diabetes considering her family history is the same as Cherise’s?
8-What are the dietary recommendations for Adolescents with Elevated Triglycerides?
9-Cherise’s LDL cholesterol was elevated, what is considered unacceptable for adolescents?
10-What could Cherise and her mother do together to improve prognosis?
CLINICAL CASE STUDY an 18 ear-old girl and high school senior who saw a nurse at the Cherise is clinic. Whil her medical the noted that rise had frequent headaches and fatigue. Cherise's blood pressure reading fel into the 92nd The school nurse referred her community clinic for a more thorough evaluation A physician's assistant (PA) the community clinic took a social history d performed a physical examination on Cherise. An SMR stage of 5 was noted. The PA noted that Cherise's BMI was at the 94th percentile for her age and gender. Her blood pressure registered at the 94th percentile. The family history revealed a strong family history of cardiovascular disease diabetes and renal disease. Cherise thought her father may be taking medication for his cholesterol and blood pressure, but reported no health issues for her mother. No signs of acanthosis nigricans were noted on the physical examination Laboratory results show that Cherise had elevated total, non-HDL, and LDL cholesterol levels along with a marginally low HDL level. The liver enzyme and blood glucose values were at the upper end of normal. A re ferral was made for Cherise to see a registered dietitian/nutritionist for diet and exercise counseling The outpatient dietitian/nutritionist (RDN) reviewed Cherise's medical history, confirmed her family history of cardiovascular disease, and mea sured her height and weight. Cherise's BMI value plotted at the 94 per centile. The RDN completed a 24-hour dietary Cherise, With the last thing she had eaten that day and working backward to a complete and accurate recall. The RDN also inquired about usual dietary patterns and physical activity as well as the presence of any food allergies/intolerances and avoidances. didn't Cherise reported usually skipped breakfast because she that she have to eat in but often Cherise ate most days was from the store food of usually a the vending machine at 10:30 AM, which consisted snack from a juice drink. occasionally she would granola bar or a bag of chips and a skipped purchase tacos or a burger, but generally she went unch. a la cart lunches of time she Chori t of at 2 nm each day, at which mlExplanation / Answer
1) If Cherise were 17 years old her blood pressure would be classified as pre-hypertensive. This condition occurs because the blood pressure is higher than the normal and close to the hypertensive BP.
2) Based on the BMI readings of the first clinic she has 94 percentile. This shows that her weight is higher than her height and age. This shows that Cherise is overweight.
3) The tests that can be recommended Cherise are blood pressure monitoring, urine test, blood test, EKG, waist circumference measurement. All these tests will help us examine the condition more closely.
4) The Child 1 diet is specific to cardiovascular health integrated lifestyle.
The diet plan will include;
Avoid sugar or limit use of it
Avoid trans fat
Encourage consumption of high fiber food
Drink enough water
Limited use of sodium and salt.
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