Discussion: Teen Case Study Jordan Is A 14-Year-Old Middle S

Discussion: Teen Case Studyjordan Is A 14 Year Old Middle School Stude

Jordan is a 14-year-old middle school student who weighs 275 pounds and is 5’6” tall. Over the past 2 years, he has gained 60 pounds, has begun to withdraw from social activities, and has avoided other students due to bullying from others his age about his weight and appearance. Recently, Jordan has been missing a significant amount of school, especially on days he has gym class. His parents are both of average height and weight. His mother attributes his weight to genetics, referencing his grandfather William, who was "husky" and died suddenly of a heart attack at 44. She believes that "fat genes" run in the family and that nothing can be done about it. Jordan reports that he sometimes goes days without eating but becomes extremely hungry afterward, feeling he could "eat the couch." He has been diagnosed with gallbladder disease, experiencing symptoms such as mild pain post-eating, radiating from the midepigastric region to the right upper quadrant and right subscapular area.

Paper For Above instruction

The initial assessment of Jordan should encompass a comprehensive overview of his physical, psychological, and social health status. Physically, vital signs such as blood pressure, heart rate, respiratory rate, and temperature should be taken, alongside weight, height, and calculation of BMI to objectively evaluate his overweight status. It is also crucial to assess for signs of comorbidities, including hypertension, insulin resistance, or sleep apnea. A detailed history of dietary patterns, physical activity levels, and weight-related behaviors should be gathered to understand his nutritional intake and activity levels. Given Jordan’s recent gastric symptoms and gallbladder disease, an abdominal assessment, including inspection, palpation, and auscultation, should be performed, focusing on tenderness, rigidity, or palpable masses. Laboratory tests, such as liver function tests, lipid profiles, and glucose levels, may be warranted based on the clinical presentation.

Psychosocial assessment is equally vital. This includes exploring Jordan’s emotional well-being, self-esteem, and social interactions, especially considering reports of withdrawal and bullying. Identifying signs of depression, anxiety, or low self-esteem can guide psychological support interventions. Establishing a supportive environment that fosters open communication is essential to address feelings of shame or shame-related behaviors. Family dynamics and support systems should also be evaluated, including understanding parental attitudes towards his weight and lifestyle. Lastly, a review of his current medications and any previous weight management attempts or interventions will help tailor a personalized care plan.

Educational components for Jordan based on choosemyplate.gov and gallbladder disease info

Engaging Jordan in understanding balanced nutrition is fundamental. Based on choosemyplate.gov, education should focus on the importance of incorporating a variety of food groups into daily meals—fruits, vegetables, grains, protein sources, and dairy—while limiting saturated fats, sugar, and processed foods. Emphasizing portion control and the significance of regular, consistent meal times can help regulate hunger and prevent overeating, which is especially relevant given his history of irregular eating patterns. Teaching about nutrient-dense foods that support overall health and may help reduce gallbladder symptoms, such as high-fiber options (e.g., whole grains, vegetables, fruits), is beneficial.

Regarding gallbladder disease, it is essential to teach Jordan about dietary modifications. He should avoid high-fat foods, fried items, and rich desserts that can exacerbate symptoms. Instead, he should opt for lean meats, low-fat dairy, and cooking methods like baking, steaming, or grilling. Smaller, more frequent meals can help reduce the workload on the gallbladder and prevent postprandial pain. Hydration is equally important; encouraging water intake over sugary beverages supports digestion and helps maintain body functions.

Furthermore, lifestyle-modification education should include the significance of gradual weight loss through appropriate dietary choices and increased physical activity, tailored to Jordan’s abilities and medical considerations. Regular physical activity, substantiated by medical approval, can improve metabolic health, mood, and self-esteem. Education should also address psychosocial aspects—helping Jordan develop healthier self-image and resilience against bullying and social withdrawal.

High-priority nursing diagnoses based on assessment and scenario

Two high-priority nursing diagnoses for Jordan include:

1. Imbalanced Nutrition: Less Than Body Requirements related to poor dietary intake, fear of eating due to hunger and previous irregular eating patterns, and gastrointestinal discomfort stemming from gallbladder disease.

This diagnosis addresses the urgent need to establish healthier eating habits that support growth, weight management, and gallbladder health. Implementing nutritional education, monitoring intake, and collaborating with dietitians are essential steps.

2. Risk for Social Isolation related to bullying, withdrawal from social activities, and decreased self-esteem secondary to weight-related stigma and physical discomfort.

Addressing this diagnosis involves psychosocial support, counseling, and fostering a supportive environment to improve Jordan’s social interactions, self-esteem, and mental health outcomes.

Implementing care strategies targeting these diagnoses with multidisciplinary involvement—including nutritional guidance, psychological support, and education—can significantly enhance Jordan’s overall health and well-being.

References

  • ChooseMyPlate.gov. (2020). Dietary Guidelines for Americans. U.S. Department of Agriculture. https://www.choosemyplate.gov
  • Burgeon, F. J. (2019). Gallbladder Disease and Diet. Journal of Gastrointestinal Surgery, 23(4), 620–629.
  • American Academy of Pediatrics. (2016). Family Nutrition and Physical Activity. Pediatrics, 138(5), e20160265.
  • Jensen, C. D., & Hayes, M. (2021). Obesity in Adolescents: Etiology and Management. Pediatrics & Adolescent Medicine, 35(3), 102–109.
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2022). Gallstones. https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones
  • Fletcher, R. H., & Berman, W. (2018). Nutrition in Adolescents. Journal of Clinical Nutrition, 28(1), 11–20.
  • Sharma, A., & Shayman, J. (2020). Obesity and Causes of Gallbladder Disease. World Journal of Gastroenterology, 26(15), 1705–1715.
  • American Psychological Association. (2019). Addressing Body Image and Self-Esteem. APA Web-based Publications.
  • Greene, J. C. (2017). The psychosocial impact of weight-based teasing on adolescents. Journal of School Nursing, 33(2), 119–125.
  • Harrison, G., & Knapik, J. (2018). Nutrition and Physical Activity Interventions for Adolescents. Journal of Pediatric Care, 9(2), 43–49.

Related Assignments