Question

Case Study – The Davis Family

Nutrition through the Life Cycle

A category 5 hurricane is heading toward the Gulf Coast. An evacuation order has been issued. The Davis family has two days to get on the road. They will be taking Grandma Davis and traveling “caravan style” with their two children, Ashley and Jonathan, along with their families. They have no relatives to stay with out of the path of the hurricane. Hotels are all booked up for at least 300 miles; therefore, the family will likely stay in a shelter set up by FEMA 100-200 miles north. Kevin and Brianna are close to Ashley and her family. However, they don’t see Jonathan as often. He works out of town a lot. He has moved in with a new girlfriend, an older woman with two kids. They have not met her yet. The Davis’ have filled their cars and obtained cash for the trip. They have gotten their medications organized, with a month’s supply ready to go. They are in the process of packing food and drink. They don’t know how long they will be gone. The last hurricane, 20 years ago, displaced people for three to four weeks. They are quickly trying to purchase the foods and drinks they will need, but the store shelves are emptying fast.

Kevin and Brianna are 60 years old. Kevin is relatively healthy. He is overweight and takes medicine for hypertension and hyperlipidemia. Brianna has type 2 diabetes, she is obese, and takes metformin to control her blood sugar. She also takes medicine for hypertension and hyperlipidemia. Both of them have good functional ability.

Kevin’s mother, Grandma Davis, has been living with them for two years. She has had Parkinson’s disease for seven years. She is showing signs of dementia. She walks with a walker and needs help with all activities of daily living. She is incontinent with bowels and bladder. Constipation has been a continuous problem. She can feed herself with supervision. She is on a pureed diet due to chewing and swallowing problems. She is on 11 different medications, including hydrocodone for pain and levodopa for the Parkinson’s disease.

Ashley and her husband, Todd, have three children. Their six-year-old boy, Caleb, has ADHD. He is on medication, which interferes with his appetite. He is at the 9^th percentile on the CDC growth charts for weight-for-age and BMI. Without the medication, he has poor impulse control and is constantly picking on his sister and annoying everyone in sight. His three-year-old sister, Sarah, is healthy, but her parents believe she is an extremely picky eater. They have been giving her Pediasure twice a day in case she is not getting what she needs from her food. The three-week-old baby boy, Ethan, is exclusively breastfed.Jonathan, Ashley’s twin brother, recently moved in with an older woman, Billie Jean. Billie Jean is 5’7” and weighs 100 pounds. Jonathan doesn’t know it yet, but Billie Jean is addicted to prescription opioid painkillers. Jonathan has no biological children, but Billie Jean has a 15-year-old daughter, Crystal. Crystal just found out she is 8 weeks pregnant, but she has not shared that information with her family yet. Billie Jean also has a nine-year-old son, Billy Bob. He has cerebral palsy. He has quadriplegia and has been on a G-tube-feeding since infancy. Now, he is given a bolus feeding of Pediasure, 8 ounces 6 times a day. He has a paid caregiver eight hours a day. However, for the hurricane evacuation, the family will have to take care of his needs on their own.

The three families are in constant communication, getting ready for the trip. They will take four vehicles:

1.         Kevin and Brianna’s SUV with Grandma Davis

2.         Ashley and Todd’s SUV with their 3 children: Caleb, Sarah, and Ethan

3.         Jonathan’s late model Ford crew-cab

4.         Billie Jean’s 2000 Chevrolet Impala with Crystal and Billy Bob

In two days they will all meet at Kevin and Brianna’s house and start driving north. When they are out of harm’s way, they will look for a shelter.

Instructions: Write a two- to three-page essay. Double spaced, 12-pt font. Identify and discuss 5 nutrition related problems or potential problems in the Davis family. Offer recommendations for dealing with the nutrition issue in the context of the current crisis situation.

Answer 1

Answer :

Five nutritional related problems in Davis family :

1. Obesity

2. Hypertension and hyperlipidemia

3. Diabetes mellitus.

4. Anorexia

5. Malnutrition

6. Nutrientional anemia.

1.Obesity and 2.hypertension and hyperlipidemia and 3. type 2 diabetes mellitus : obesity is due to heriditory, or due to dietary habits, in these case study Kevin is having over weight and taking medicine for hypertension and hyperlipidemia.

* over weight leads to finally obesity.

* so education is important to the Mr. Kevin regarding her activity and healthy eating habits and exercises.

* Mrs. Brianna having obesity and hypertension and hyperlipidemia.

* so we need to give health education regarding salt restriction diet.

* low fat and low cholesterol diet.

* education regarding physical exercises and activities.

* and she is having diabetes also type 2.

* so she needs education regarding daily monitoring of glucose levels, low carbohydrate diet, physical exercises, and healthly eating habits.

* so this obesity and hypertension and hyperlipidemia can causes the severe coronary heart diseases which may leads to death.

4. Anorexia :

It is one of the eating problem, loss of appetite, inadequate intake of food, and low weight.

* according to study Ashley and her husband Todd have three children. In those 6 years old boy Caleb have Attention deficit hyper activity disorders, and he is on medications ,these medications are interfering with the taking of food.

* so he is having anorexia, which may leads to poor intake and malnutrition may come to children.

* so we will abserve the poor weight gain and nutritional deficiency disorders.

* so that time we need to encourage the child to eat, what eve the food she likes that we need to provide.

* by changing mood or by giving some playing dolls, we need to maintain the diversional therapy and give food to the child, to maintain normal weight.

5. Malnutrition :

Billie Jean have 9 years old son in these case study, his name is Billy Bob he had cerebral palsy and he is having quadriplegia and he is on gastrointestinal tube feeding, taking care by care giver.

So we can abserve malnutrition in these case.

* malnutrition means lack of nutrients supplementation to the body leads to poor weight gain and disease recovery.

* so here adequate care must be taken regarding nutrientional supplementations of this child.

* provide well balanced nutrientional supplementation.

6. Nutritional anemia :

According to this case study Cristal is 15 years old she was in pregnancy, early pregnancy leads nutrientional anemia.

* because iron needs increases during pregnancy to maintain fetal growth.

* so iron supplements and folic acid supplements are very essential.

* like green leafy vegetables and milk, meet, egg are very essential.

* so that we can reduces risks of fetal growth.

These are the nutritional related problems and their recommendations in Davis family.