Question

As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further.

Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done.

A dietary assessment is also completed.

Breakfast: 2 slices wheat toast with peanut butter

banana

                   6 oz coffee, black

Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes

              3 tablespoons of Italian dressing

              A breadstick

              2 oatmeal cookies

              12 oz of iced tea

Snack: Granola bar and an apple

Dinner: 1 cup of brown rice

               1 bowl of black bean chili

               1 square of corn bread

               ½ cup mixed fruit

               ½ cup grilled vegetables

               12 oz Diet Coke

Snack: 2 cups of popcorn

             8 oz of lemonade

Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life.

Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

1. From your visual exam the dietary intake and the blood test, what mineral is lacking in Susan’s diet?

2. A deficiency of this mineral over time will result in low hemoglobin levels and a diagnosis of ____________.

3. Provide Susan with three reasons that this mineral may be low.

4. Explain to Susan why she is feeling tired and cold.

5. What is the recommended amount of water that a female should consume daily? How much of it should come from fluid itself?

Answer 1

1. Iron is lacking in Susan's diet

2. Anemia

3. * Susan does not have enough iron in her diet

* As she is a vegetarian, not taking iron content foods.

* Endurance training

4. Susan does not have enough red blood cells to carry oxygen to different parts of the body and the symptoms like tiredness and cold is due to lack of oxygen.

5. About 2.7 litres of fluid a day for women. This recommendation cover the fluids from water and other beverages. About 20% of fluids intake comes from food ans 80% from drinks.