Ms. Wooly brought her daughter, Mary, age 16, to the health care center to be seen by the nurse for a referral to the physician. Together, they tell the nurse that Mary has had nausea, vomiting, and headaches for the past 2 weeks. She has vomited "almost every day." Ms. Wooly began to cry as she tells the nurse that Mary does not remember the date of her last menstrual period and that she is

Question

afraid that Mary is pregnant. During this interchange, Mary appears stoic and does not cry or have any verbalizations. After a blood test that confirmed the pregnancy, Ms. Wooly became calmer. A prenatal assessment was begun. Ms. Wooly answered most of the questions even though they were directed at Mary.

Last menstrual period was estimated to be 2 months ago.

Menses onset began 4 years ago.

Ht: 5?8? Wt: 125 lbs

Medium frame size

She described her usual dietary intake as including hamburgers, hot dogs, chips, candy, and colas. Mary denies alcohol, drug, or cigarette use. Mary would not discuss the father of the child, nor did she volunteer any additional information. It is evident that Mary has some urgent needs that must be addressed during this visit. Mary is young and will need time to accept the pregnancy, but she must also begin to eat properly to meet her nutritional needs and those of the infant.

When Mary hears the nurse tell her she will need to increase her caloric intake, her first response to the nurse was, "More chips, candy, colas." What is the nurse's response?

Answer 1

The nurse must help Mary understand that the weight gain must be from desirable foods that are nutrient dense and emphasize the importance of choosing a varied diet. The empty calories that Mary prefers provide no nutritional value for her or the baby.?