Reference no: EM133523806

Ashleigh is a 10 year-old 5th grade student who has come in for a physical exam. Ashleigh is 4 feet 6 inches tall and weighs 125 pounds. Her doctor calculates her BMI at 30.1 (greater than the 97th percentile for her age). Ashleigh's doctor asks about her diet and physical activity because he is concerned about her obesity. Her mother reports that Ashleigh has become 'lazy' and does not like to play outside with her friends after school. She says Ashleigh has become more irritable than usual and complains about helping with household chores. Her mother worries that she might be depressed but can think of no family issues that might have caused this behavior.

A food history reveals that Asheigh sometimes skips breakfast or has cereal and toast in the morning. She takes chips, a juice drink, and a cheese sandwich made with white bread for lunch; she has a toaster pastry or cookies with milk for a snack after school. Ashleigh doesn't particularly like meat and frequently asks for buttered pasta with cheese for dinner. Ashleigh says she eats vegetables 'when my mom buys them.'

Lab work reveals the following Ashleigh's :

Ashleigh's hemoglobin level is normal. (A hemoglobin test measures the amount of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs)

Ashleigh's serum serum iron is low. (Serum iron is a measurement the amount of circulating iron that is bound to transferrin and serum ferritin, a protein that stores and releases iron.)

Asheigh's transferrin is moderately elevated (transferrin is the main protein in the blood that binds to iron and transports it throughout the body), and

Asleigh's transferrin saturation is low (transferrin saturation tells the physician how much serum iron is bound to transferrin).

With this in mind, and based on her history discuss

1. What nutrient deficiencies you suspect might contribute to Ashleigh's symptoms.

2. What stage of iron deficiency does her lab work indicate. How would you classify Ashleigh's condition. Explain.

3. What are some meal planning strategies that Asleigh's mother could follow to improve her intake of iron and zinc?

4. What are some meal and snack ideas that could improve Ashleigh's intake of essential minerals mentioned in chapter 13?

5. If her doctor prescribes an iron supplement, what practical advise would you give Ashleigh about when and how to take it?

6. What cautions would you give Ashleigh's mother regarding excessive iron supplementation.