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Susan Smith, a white, 15 year old, single adolescent, is 8 weeks pregnant. Her height is 5’3", her pre-pregnancy weight is 95 pounds, and her current weight is 93 pounds. Her hemoglobin is 10 gm/dl. This is her first pregnancy. Her age at menarche was 13 years. Her usual dietary intake is as follows:

Breakfast: Instant Breakfast with milk
Lunch: Skips lunch to go to aerobics
Snack: Chips, candy, or cookies with a diet drink
Dinner: Eats with family

• Meat or meat casserole
  Starch
  Green or yellow vegetable
  Bread
  Iced tea

Susan’s father is out of work and her mother works part time in a day care center for children. She has 3 brothers and 2 sisters, all of whom are in school. They live in a rented 3-bedroom house. Their income is $11,500 per year. While Susan’s parents are concerned about her pregnancy, they are supportive of her. Susan’s boyfriend, who is 16, wants to get married, but she wants to wait until they finish high school.

1. What factors contribute to Susan being a high risk pregnancy?
2. Are there any factors in Susan’s case study that are favorable to a successful pregnancy? If yes, what are they?
3. How much weight should Susan gain during her pregnancy? What factors did you consider when estimating an appropriate weight gain?
4. What would you tell her if she says she wants to gain less weight so that her infant will be smaller and the delivery will be easier?
5. What changes, if any, would you recommend in her diet? Be specific and provide information that would be helpful to Susan.