Susan Smith, age 11, is in clinic with her mother for a rout…
Susan Smith, age 11, is in clinic with her mother for a routine check-up and immunizations. Just recently, Susan has been teased at school on several occasions about being fat and that is Ms. Smith’s primary concern because she is otherwise “very healthy.” Susan has always been a big girl, and there have been no dramatic changes in weight. She has a good appetite as always, likes most foods, and mom tries to “cook healthy” because her husband has been told he has a somewhat elevated cholesterol level. Both parents are moderately overweight, and Ms. Smith gains and loses 10 to 20 pounds on a regular basis. Susan is in the 5th grade, loves school, and does well; however, she does become anxious whenever she must take any type of test, and she hides in the coatroom when she looks at her test results. She has several school and neighborhood friends and enjoys playing with them. She lives with her mom, dad, and two younger brothers (normal weight). This summer, Susan will be home by herself after summer school for 2-3 hours a day throughout the 6-week session. Susan’s past health history is unremarkable, her immunizations were current upon kindergarten entrance, review of systems is negative, and her physical exam reveals no significant findings other than weight. Her BMI (body mass index) has remained steady over time at the 90th percentile, and her sexual maturity rating is 1. Obviously, there is much additional information that would be helpful, but write an assessment that reflects your basic thoughts identifying all issues that ideally need to be addressed. Include routine health supervision as well as any additional issues you wish to address. Then, create a succinct, but detailed, plan to accompany your assessment, be sure to provide rationale Assessment: 1. 2. 3. 4. 5. Plan: Rationale: Considering all you’ve learned about well child care and psychosocial issues, prepare a rationale so that you reflect knowledge of why you have decided on your plan of action. Number your rationale to correspond with your plan.
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