Case Study Preschool Child
Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father, who both work full-time, and his infant sister. Their extended family lives in a different state more than 100 miles away. Both parents are of average height and in good health. Ricky’s mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him. Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed. Ricky’s mother is quite frustrated and concerned that he will become malnourished. Reflective
Questions
1. What additional assessment information would you collect?
2. What questions would you ask, and how would you further explore this issue with the mother?
3. In what ways does the distance of the extended family influence this family’s approach to health promotion?
4. What factors would you consider to determine whether malnourishment is a factor in this family?
Sample Solution
Additional Assessment Information
To further assess Ricky's eating habits and the family's approach to mealtimes, I would collect the following additional information:
- Detailed food diary: Ask the mother to keep a detailed food diary for Ricky for 3-7 days. This should include all foods and drinks consumed, as well as the time and quantity of each.
- Mealtime observation: Observe a family mealtime to assess the family's interactions and Ricky's eating behavior.
Full Answer Section
- Growth chart: Review Ricky's growth chart to assess his growth and development.
- Nutritional assessment: Perform a nutritional assessment to identify any potential nutrient deficiencies.
- What are Ricky's typical food preferences?
- What are the biggest challenges you face at mealtimes?
- What have you tried to do to get Ricky to eat more?
- What are your concerns about Ricky's eating habits?
- How do you and your husband approach mealtimes?
- What role does food play in your family's culture?
- How do you think the distance of your extended family influences your approach to health promotion?
- The family may be less likely to have access to traditional family recipes and cooking methods.
- The family may be more likely to rely on processed foods and convenience meals.
- The family may have less support from other family members in terms of meal planning and preparation.
- The family may be less likely to have exposure to a variety of healthy foods.
- Ricky's growth chart: Is Ricky's weight and height within the normal range for his age?
- Ricky's food diary: Is Ricky consuming a variety of healthy foods from all food groups?
- Ricky's nutrient intake: Is Ricky meeting his nutritional needs for essential nutrients such as protein, carbohydrates, fat, vitamins, and minerals?
- Ricky's physical exam: Does Ricky have any physical signs or symptoms of malnutrition, such as pale skin, brittle hair, or muscle wasting?
- Providing education on healthy eating and nutrition
- Developing a meal plan that meets Ricky's nutritional needs
- Helping the family to identify and address any barriers to healthy eating
- Providing referral to a registered dietitian or other healthcare professional for additional support