Jordan is a 14 year old middle school student, weighing 275 pounds and is 5’6” tall. Over the
past 2 years, he has gained 60 pounds, as he has begun to withdraw from social activities, and
avoid other students, due to bullying from others his age about his weight/appearance. Lately,
Jordan has been missing a great deal of school too, particularly on the days he has gym. Jordan’s
parents are both average in height and weight, and Jordan’s mother says that he just takes after
his grandfather William, who “was a husky man, and died of a sudden heart attack at the age of
44”. She says “We just have fat genes in the family; you can’t do anything about that”!
He has been told he had “no willpower, or is weak, or that he needed to change his lifestyle, eat
less and exercise more.” Jordan says “I go for a couple days without eating, but then I get so
hungry that I could eat the couch”!
Jason has recently been diagnosed with gallbladder disease and has symptoms that typically
occur after eating that include mild pain in the mid-epigastric region, radiating to the right upper
quadrant of the abdomen and right subscapular area of the body.
You are the nurse assigned to Jason.
1. What would you include in your initial assessment data based on the scenario provided?
The first thing I would do would be confirm the diagnosis with an ultrasound scan. I would also
assess his diet and physical activity. I would ask him to keep a diet and exercise journal so that I
could assess this more closely on the follow-up visit.
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, 2. What would you teach Jordan based on the RDA Recommended Daily Allowance from
the choosemyplate.gov link discussed in lesson 1, and the information provided about
gallbladder disease provided in lesson 6?
I would teach him not to try to lose weight too quickly because that can exacerbate the issue.
Next, I would help him plan a diet that includes a lot of fibrous foods, like oatmeal and brown
rice, and healthy fats, like the kind you get from fish and olives, because they are beneficial to
the gallbladder by increasing contraction. I would also encourage him to eat less sugar and
refined grains.
3. Based on your assessment data and the information from the scenario what might be two
high priority Nursing Diagnosis to guide Jason’s plan of care?
The highest priority would be changing his diet to improve gallbladder function and decrease his
chances of developing cholelithiasis. Secondly, I would encourage exercise, which will improve
his physical health and also decrease his chances of developing cholelithiasis.
References
Grodner, M., Roth, S. L., Walkingshaw, B. C., & Grodner, M. (2012). Nutritional foundations
and clinical applications: A nursing approach (6th ed.). St. Louis, MO: Mosby/Elsevier.
US National Library of Medicine. (2016, September 28). Gallbladder Diseases: MedlinePlus.
Retrieved from https://medlineplus.gov/gallbladderdiseases.html
This study source was downloaded by 100000827506713 from CourseHero.com on 08-06-2022 04:34:24 GMT -05:00
https://www.coursehero.com/file/17592904/NR-228-Discussion-6/
past 2 years, he has gained 60 pounds, as he has begun to withdraw from social activities, and
avoid other students, due to bullying from others his age about his weight/appearance. Lately,
Jordan has been missing a great deal of school too, particularly on the days he has gym. Jordan’s
parents are both average in height and weight, and Jordan’s mother says that he just takes after
his grandfather William, who “was a husky man, and died of a sudden heart attack at the age of
44”. She says “We just have fat genes in the family; you can’t do anything about that”!
He has been told he had “no willpower, or is weak, or that he needed to change his lifestyle, eat
less and exercise more.” Jordan says “I go for a couple days without eating, but then I get so
hungry that I could eat the couch”!
Jason has recently been diagnosed with gallbladder disease and has symptoms that typically
occur after eating that include mild pain in the mid-epigastric region, radiating to the right upper
quadrant of the abdomen and right subscapular area of the body.
You are the nurse assigned to Jason.
1. What would you include in your initial assessment data based on the scenario provided?
The first thing I would do would be confirm the diagnosis with an ultrasound scan. I would also
assess his diet and physical activity. I would ask him to keep a diet and exercise journal so that I
could assess this more closely on the follow-up visit.
This study source was downloaded by 100000827506713 from CourseHero.com on 08-06-2022 04:34:24 GMT -05:00
https://www.coursehero.com/file/17592904/NR-228-Discussion-6/
, 2. What would you teach Jordan based on the RDA Recommended Daily Allowance from
the choosemyplate.gov link discussed in lesson 1, and the information provided about
gallbladder disease provided in lesson 6?
I would teach him not to try to lose weight too quickly because that can exacerbate the issue.
Next, I would help him plan a diet that includes a lot of fibrous foods, like oatmeal and brown
rice, and healthy fats, like the kind you get from fish and olives, because they are beneficial to
the gallbladder by increasing contraction. I would also encourage him to eat less sugar and
refined grains.
3. Based on your assessment data and the information from the scenario what might be two
high priority Nursing Diagnosis to guide Jason’s plan of care?
The highest priority would be changing his diet to improve gallbladder function and decrease his
chances of developing cholelithiasis. Secondly, I would encourage exercise, which will improve
his physical health and also decrease his chances of developing cholelithiasis.
References
Grodner, M., Roth, S. L., Walkingshaw, B. C., & Grodner, M. (2012). Nutritional foundations
and clinical applications: A nursing approach (6th ed.). St. Louis, MO: Mosby/Elsevier.
US National Library of Medicine. (2016, September 28). Gallbladder Diseases: MedlinePlus.
Retrieved from https://medlineplus.gov/gallbladderdiseases.html
This study source was downloaded by 100000827506713 from CourseHero.com on 08-06-2022 04:34:24 GMT -05:00
https://www.coursehero.com/file/17592904/NR-228-Discussion-6/
