FCS 217

Case Study #1 – Preconception

Client information

Jodi is a 36-year-old female who is planning to have her third child with her husband, Mike. Her history indicates that she had her children within one year of each other, with her last child being delivered when she was 35. She and her husband meets with you (dietitian) for advice as to how to make changes to ensure at her age they will have the best outcome with their next pregnancy.

Jodi had an annual checkup with her primary care physician (family doctor) in the past month. She explained her concerns with planning her next pregnancy. She referred her to an obstetrician, and lab values and other information was documented. The following is objective information from her consultation:

Height: 5’4” Weight: 190 lbs.

Labs:  Total cholesterol:  245 mg/dl   HDL : 30 mg/dl  LDL: 140 mg/dl  Fasting glucose: 115 mg/dl

At your first initial consultation, you collect more subjective information from Jodi and her husband.

Subjective History:

In her past pregnancies, Jodi was unable to breastfeed, and she indicated that after each pregnancy, she retained 20 lbs. or so of weight and had trouble losing her post pregnancy weight gain. She has never been a milk drinker and has tried to avoid dairy products as she has heard dairy products are not good for weight control. Jodi also is not fond of fruits and vegetables, and did not take prenatal vitamins with her previous pregnancies. During her pregnancies, she wanted to make sure she supplemented with protein powders to ensure she had enough protein, as she indicated she also followed a low carbohydrate, high protein diet. She is thinking about taking herbal supplements as she has heard they help with decreasing the risk of complications of pregnancy. She wants to plan to gain less weight in her next pregnancy, and wants to limit her total pregnancy weight gain to 20 lbs. Her husband, Mike, has struggled with his weight gain in the past three years, and is a smoker.

  1. Evaluate Jodi’s height/weight. What is her BMI? What is your professional conclusion based on these figures? How can this affect her future pregnancy?
  2. List the four lab values of interest provided. For each, evaluate what the levels indicate. For EACH, also provide and explanation for each of your evaluation. For EACH, provide a brief explanation as to how this could affect Jodi’s pregnancy. Finally, for EACH, provide your dietary suggestions as to improve. (5 points per lab evaluation/questions = 20 total points)
  3. Based on the subjective information from Jodi and her documented history, list 5 things you observed that can be improve a pregnancy outcome. Number each or use “a., b., c.” so we can see each of the five responses clearly. You may need to use outside sources for more complete answers, so provide a citation (link) for your sources. If you use the text, you do not need to cite this source (we have it).
    1. Address for each: the risk factor, how this can affect preconception/pregnancy, dietary/health suggestions you would make to help Jodi and Mike to plan for the best pregnancy outcome. (There are more than 5 issues in this case study, and you can choose the 5 you feel are most important).
    2. 5 separate responses X 5 points each = 25 points total