Should her parents be included? Why or why not? What will be ...

[darbym82]

Should her parents be included? Why or why not?
 
  What will be an ideal response?

Question 2

From your reading of Mrs. Joaquin's history and physical, what signs and symptoms did she have that correlate with her chronic kidney disease?
 
  What will be an ideal response?

[aidanmbrowne]

Answer to Question 1

 Family counseling is very important and improves weight management outcomes.
 Degree of counseling format depends on the family dynamics and should be determined by the professional's discretion (ex.: group vs. individual, caregiver and child vs. parent, etc.)
 Parents need to be ready to make lifestyle changes to support the child/adolescent with cognitive behavior strategies.
 Parental modeling has advantages in children under 12 years of age
 Components include:
- nutrition education on lifestyle behaviors and their relationship to chronic disease development
- modification of the home/school environment to enable the adolescent to make wise food choices
- self-monitoring and motivation to change by modeling behaviors and contracting

Answer to Question 2

 Anorexia
 N/V
 4 kg weight gain in the past 2 weeks
 Edema in extremities, face, and eyes
 Malaise
 Progressive SOB with 3-pillow orthopnea
 Pruritus
 Muscle cramps
 Inability to urinate
 Declining GFR
 Increasing creatinine and urea concentrations
 Elevated serum phosphate
 Normochromic, normocytic anemia
 Yellow-brown cast to skin