NURS 6512N-26:Advanced Health Assessment
INITIAL POST
Health Issues and Risks of Children’s Weight
5-year-old girl of normal weight with obese parents
Since parental obesity is a risk factor in child obesity (Fuemmeler, Lovelady, Zucker,
&Østbye, 2013), it is important to look at familial traits in regards to weight issues. It has been
noted that body mass index (BMI) is twenty-five to forty percent inheritable (Anderson &
Butcher, 2006), and one of the biggest factors noted to cause obesity (Sahoo et al., 2015). As
such, my patient runs a much higher risk for obesity than a child with average-sized parents with
a normal BMI. Childhood obesity can not only be linked to poor physical health, with increased
risk of developing sleep apnea, Type II diabetes, asthma, cardiovascular disease, high
cholesterol, insulin resistance, and menstrual abnormalities, but also social and emotional issues
related to poor self-esteem dude to social stigmatization and bullying (Sahoo et al., 2015). This
increased social isolation can lead to a further sedentary activities and further weight gain (Sahoo
et al., 2015). Furthermore, school performance can also be negatively affected due to increased
school absence, especially when a chronic condition also exists (Sahoo et al., 2015).
Information Needed for Weight Assessment
To assess the potential risks associated with childhood obesity, I would need to know
more about the parent’s medical history, as well. If the parental obesity is related to a disease
process, the child could also be at risk for developing the disease. Additionally, I would also
need information regarding maternal health during pregnancy, particularly any history of
gestational diabetes, which can lead to offspring metabolic disorders (Lehnen, Zechner, & Haas,
2013). Specific questions I would ask would be:
1. Did the mother have any issues during her pregnancy, such as Gestational Diabetes?
2. Does she (the child) get at least one hour of physical activity each day?
3. What kind of foods does she eat and drink?
4. How much television (TV) time does she get each day?
Strategies for Healthy Behaviors
Family plays a critical role in developing and maintaining healthy behaviors in children
(Faith et al., 2012). Because weight discussions can be sensitive, I would turn the discussion
more towards improving general health and not focus on weight loss or maintenance. I would
discuss an appropriate healthy diet with the parents, focusing on foods that improve health and
are nutritionally sound, and also discuss adequate hydration specific for children, which avoids
sugary and caffeinated drinks. I would also focus on limiting TV time, as higher structured
thinking is shown to develop more effectively through unstructured and social play (Hill et al.,
2016). Encouraging physical activity instead of TV time would encourage a healthier lifestyle for
the mind and the body.
References
Anderson PM, Butcher KE. (2006) Childhood obesity: Trends and potential causes. Future
Child, 16(1). Retrieved from http://files.eric.ed.gov/fulltext/EJ795889.pdf
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel's guide to
physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Faith, M. S., Van Horn, L., Appel, L. J., Burke, L. E., Carson, J. A., Franch, H. A., ... &Kral, T.
V. (2012). on behalf of the American Heart Association Nutrition and Obesity
Committees of the Council on Nutrition; Physical Activity and Metabolism; Council on
Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on
Cardiovascular Nursing; Council on Epidemiology and Prevention, and Council on the
Kidney in Cardiovascular Disease. Evaluating parents and adult caregivers as “agents of
change” for treating obese children: evidence for parent behavior change strategies and
research gaps: a ....Circulation, 125. Retrieved from
https://professional.heart.org/professional/ScienceNews/UCM_436920_Parents-as-
Agents-of-Lifestyle-Change-for-Obese-Children-A-Call-to-Action.jsp
Fuemmeler, B. F., Lovelady, C. A., Zucker, N. L., &Østbye, T. (2013). Parental obesity
moderates the relationship between childhood appetitive traits and weight. Obesity (Silver
Spring, Md.), 21(4), 815–823. http://doi.org/10.1002/oby.20144
Hill, D., Ameenuddin, N., Chassiakos, Y. L. R., Cross, C., Hutchinson, J., Levine, A., ...&
Swanson, W. S. (2016). Media and Young Minds. Pediatrics, e20162591. Retrieved from
http://pediatrics.aappublications.org/content/early/2016/10/19/peds.2016-2591
Lehnen, H., Zechner, U., &Haaf, T. (2013). Epigenetics of gestational diabetes mellitus and
offspring health: the time for action is in early stages of life. Molecular human
reproduction, 19(7).doi: 10.1093/molehr/gat020
Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., &Bhadoria, A. S. (2015).
Childhood obesity: causes and consequences. Journal of Family Medicine and Primary
Care, 4(2), 187–192. http://doi.org/10.4103/2249-4863.154628
