BIOD 121 PORTAGE LEARNING EXAM 4 MODULES 20232024, Exams of Nursing

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BIOD 121 PORTAGE

LEARNING EXAM

4 MODULES

2023/

We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk. After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

1. Thinking about the ABCDE method of assessments, what 2 types of assessment did you complete on this patient?

Your Answer: Biochemical and Clinical assessment Clinical & anthropometrics We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk. After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

Question 2

1 / 3 pts

2. Using your assessment and the information you have gained from the first case study, name three diseases that Fred may be at risk for: a. b. c. Your Answer: Hyperglycemia COPD-chronic obstructive pulmonary disease arthritis 2. Using your assessment and the information you have gained from the first case study, name three diseases that Fred may be at risk for: a. Diabetes b. Hypertension, stroke, heart disease, cardiovascular disease c. Obesity d. Metabolic syndrome We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte.

Question 3

1 / 4 pts

For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk. After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

3. You explain to Fred that you reviewed his diet intake record and that there are several changes that he could make to improve his health. Using the dietary guidelines and myplate provide 4 suggestions to Fred to improve his diet and his health. (any of the below would be acceptable) a. b. c. d. Your Answer: a. vegetable b. fruits c. Grains d. proteins 1. You explain to Fred that you reviewed his diet intake record and that there are several changes that he could make to improve his health. Using the dietary guidelines and myplate

provide 4 suggestions to Fred to improve his diet and his health. (any of the below would be acceptable) a. Substitute low fat dairy or water for other beverages, decrease calorie intake from energy dense foods b. Limit sodium to < 1500 mg by limiting fast food and processed foods c. Choose whole grains over simple carbs d. Increase fruits/vegetables e. Moderation, variety and balance f. ½ plate fruits/veg and ¼ protein and ¼ whole grains g. Limit saturated fats, lacking nutrients from fruits/vegetables, increase fiber, Increase nutrient density We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk.

Question 4

6 / 7 pts

After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

4. As you discuss some of the suggestions, Fred mentions that his PCP told him that he was at risk for diverticulitis. However, he is not familiar with this term. All he knows is that he should increase his fiber. Explain to Fred what has occurred in the colon when the diagnosis of diverticulitis is made. (3 points) Include two reasons that diverticulitis occurs. (4 points) Your Answer: Small pouches pushes out through weak spots in the colon wall and become infected. what causes this is low fiber diet 4. Small pouches are formed and food particles have become stuck in the pouches. These can become infected and cause pain. Age, lack of fiber and straining lead to formation of the pouches. We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few

Question 5

5 / 8 pts

friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk. After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

5. Fred requests information on soluble fiber and insoluble fiber and how each can help improve his health. Give a brief overview and explain the difference between the two types of fiber. Give an example of a health concern or disease that each type can prevent. Your Answer: Insoluble fiber - non-fermentable, does not dissolve in water and not broken down by intestinal bacteria, improve bowl health and regularity Soluble fiber- viscous, dissolves in water and are broken down by an intestinal bacterial. Help lower cholesterol level , weight control, and reduce risk of diabetic

**Insoluble (nonfermentable) Does not dissolve in water Not broken down by intestinal bacteria Increases the stool mass Speeds passage through the large intestine Disease- diverticulitis, cancer, constipation Soluble (viscous) Does dissolve in water Is broken down by intestinal bacteria Slows glucose absorption and can lower cholesterol Provides satiety to a meal Disease- obesity, cardiovascular disease, diabetes, metabolic syndrome X We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk.

Question 6

6 / 6 pts

After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129 - 173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

6. As the session concludes, you recommend that Fred consider a vegetarian style of eating, at least for several days a week. Review the difference between a semi vegetarian, a lacto ovo vegetarian and a pesco vegetarian. Your Answer: Semi vegetarian consist of fish and poultry except for red meat Lacto ovo vegetarian consist of milk and egg but no animal flesh Pesco vegetarian- only fish but no other animal flesh 6. Semi-vegetarian usually will include fish and poultry in their diet, but no red meat. Lacto-ovo vegetarian includes milk and eggs, but no animal flesh Pesco vegetarian will include fish but no other animal flesh

Which of the following questions is NOT true of the basal metabolic rate (BMR)?

Physical activity is a component of the BMR

Define the term hyperplasia.

Hyperplasia is an increase the number of fat cells in our body

Using the guidelines for Body Mass Index someone with a body mass index of

18.5 to 24.9 would be considered.

at a healthy weight

estimates a person’s body fat by measuring the degree of

resistance to an electrical flow.

Bioelectrical Impedance

Calculate the EER for a female who is 33 years old, 5 feet 9 inches tall, 145 pounds

with a low activity lifestyle.

Activity Level PA Men PA Women

Sedentary - No exercise 1.00 1.

Low Activity - exercises the equivalent of walking 2 miles

per day at 3 - 4 mph

1.11 1.

Active - exercises the equivalent of walking 7 miles per day 1.25 1.

Very Active - exercises the equivalent of walking 17 miles

per day

1.48 1.

Males: EER = 662 - (9.53 x AGE) + PA x (15.91 x WT + 539.6 x HT)

Females: EER = 354 - (6.91 x AGE) + PA x (9.36 x WT + 726 x HT)

1 kg = 2.2 pounds

1m = 39.37 inches

Females: EER = 354 - (6.91 x AGE) + PA x (9.36 x WT + 726 x HT)

where:

AGE = 33

PA = 1.12 (from chart)

WT = 130 lbs x 1 kg/2.2 lbs = 65.9 kg

HT = 69 in x 1 m/ 39.37 in = 1.75 m

Plug in the numbers for the variables:

EER = 354 - (6.91 x 33) + 1.12 x (9.36 x 65.9 + 726 x 1.75)

Multiply the numbers inside the parenthesis:

EER = 354 - (228) + 1.12 x (616.8 + 1270.5)

Add inside the parenthesis:

EER = 354 – 228 + 1.12 x 1887.

Multiply before adding:

EER = 354 – 228 + 2113.

Add and Subtract:

EER = 2239.8 calories

1. The distribution of fat in the body is important. Males often have an

shape, often referred to as android obesity.

2. Females have a often referred to as gynoid obesity.

3. Women’s body shape often changes after.

1. apple

2. pear

3. menopause

Which person is at a greater risk for health issues related to being overweight or

obese? Explain your answer.

Janet has a BMI of 24 and a waist to hip ratio of .8. Fred has a BMI of 30 and a

waist to hip ratio of 1.0.

Fred

The desired hip to waist ratio in males is <0.9 and in females < 0.8.

A BMI of 18 - 24.9 is considered healthy

A BMI of 25 - 29.9 is considered overweight

A BMI of 30 or greater is considered obese

Exceeding the respective values would be indicative of a health risk

What table can be used to determine if an individual is in a healthy weight range,

an overweight range or is considered obese?

Would this table be appropriate for a muscular individual?

Body Mass Index Table

No it would not be appropriate

Nature and nurture both play a role in determining our weight. Mark each

statement as nature or nurture.

1. One parent is obese so their children have a 40% greater risk of being obese

.

2. Excess weight gain during pregnancy can lead to obesity.

3. Your body’s set point.

1. nature

2. nurture

3. nature

Sue wants to lose weight. Her physician has advised her to restrict her calories to

no less than per day.

1200 calories

1. Positive energy balance occurs when energy intake is greater than energy

expenditure resulting in weight.

2. A negative energy balance occurs when intake is less than energy expended

resulting in a weight.

3. Most adults should be in a state of energy balance where energy intake is

to energy output. This results in weight maintenance.

1. gain

2. loss

3. equal

Match the following behavior modification strategies with the correct statement.

A. Cognitive Restructuring

B. Chain Breaking

C. Stimulus Control

D. Contingency Management

E. Self Monitoring

1. Keeping a food diary helps you lower your fat to the recommended

amount.

2. Your kids always leave food on their plates. You hate to waste food so you

usually

Nibble on their leftovers while clearing the table. Today you pop in a piece of gum

prior to cleaning up.

3. You are tempted to eat a Snickers bars every time you go into the

kitchen.. Today you give the bars to your kids friends and decide not to purchase

more.

1. Keeping a food diary helps you lower your fat to the recommended amount.

2. Your kids always leave food on their plates. You hate to waste food so you

usually Nibble on their leftovers while clearing the table. Today you pop in a

piece of gum prior to cleaning up.

Correct Answer

B. Chain Breaking

3. You are tempted to eat a Snickers bars every time you go into the kitchen..

Today you give the bars to your kids friends and decide not to purchase more.

Correct Answer

C. Stimulus Control

E. Self Monitoring C. Stimulus Control B. Chain Breaking

As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick 2 oatmeal cookies 12 oz of iced tea Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke

Snack: 2 cups of popcorn 8 oz of lemonade Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

1. From your visual exam the dietary intake and the blood test, what mineral is lacking in Susan’s diet? Your Answer: Iron(Fe) 1. From your visual exam the dietary intake and the blood test what mineral is lacking in Susan’s diet? (Iron) As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick

2 oatmeal cookies 12 oz of iced tea Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke Snack: 2 cups of popcorn 8 oz of lemonade Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

2. A deficiency of this mineral over time will result in low hemoglobin levels and a diagnosis of. Your Answer: Iron deficiency know as anemia 2. A deficiency of this mineral over time will result in low hemoglobin levels and a diagnosis of. (anemia)

As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick 2 oatmeal cookies 12 oz of iced tea Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke Snack: 2 cups of popcorn 8 oz of lemonade

Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

3. Provide Susan with three reasons that this mineral may be low. Your Answer: Iron is a mineral, and its main purpose is to carry oxygen in the hemoglobin of red blood cells throughout the body so cells can produce energy.

1. Blood loss: Blood contains iron within red blood cells
2. Lack of iron in the diet-consumption of red meat. Calcium is the only known substance that can impair the absorption of both heme and non-heme iron. when you consume too little iron, over time your body can become iron deficient.
3. An inability to absorb iron-Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia. 3. Provide Susan with three reasons that this mineral may be low. Any of the following answers are acceptable: a. Her age, being a young female b. lack of heme iron or meat in the diet] c. high fiber intake that interferes with iron absorption d. loss of iron with her menses e. being a vegetarian f. lack of Vitamin C intake with non heme iron As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done.

A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick 2 oatmeal cookies 12 oz of iced tea Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke Snack: 2 cups of popcorn 8 oz of lemonade Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

4. Explain to Susan why she is feeling tired and cold. Your Answer: Susan feels tired and cold because her body needs iron to make a protein called hemoglobin, which is found in red blood cells. Hemoglobin helps carry oxygen around the body. When the body doesn’t have enough hemoglobin, less oxygen reaches the tissues and muscles, depriving her of energy. 1. Explain to Susan why she is feeling tired and cold. (iron is part of the hemoglobin in red blood cells. One of the major functions of red blood cells is to transport oxygen from the lungs to the cells and carbon dioxide from the cells to the lungs. When dietary intake of iron falls, the body converts the stored iron for use. As stores decline, the capability for manufacturing red blood cells declines and an iron deficiency known as anemia develops) As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick 2 oatmeal cookies 12 oz of iced tea

Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke Snack: 2 cups of popcorn 8 oz of lemonade Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

5. What is the recommended amount of water that a female should consume daily? How much of it should come from fluid itself? Your Answer: The general recommendation for total fluid intake for women is 11 cups daily. Nine cups for women should come from fluids alone. 5. What is the recommended amount of water that a female should consume daily? How much of it should come from fluid itself? (11 cups daily, nine from fluid alone. The rest can come from food sources)

As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing A breadstick 2 oatmeal cookies 12 oz of iced tea Snack: Granola bar and an apple Dinner: 1 cup of brown rice 1 bowl of black bean chili 1 square of corn bread ½ cup mixed fruit ½ cup grilled vegetables 12 oz Diet Coke Snack: 2 cups of popcorn 8 oz of lemonade

Susan’s family has a history of cardiovascular disease, and she has decided to be a vegetarian to prevent this from occurring later in life. Biochemical assessment results- the urine is dark yellow in color. Hemoglobin levels are below the normal range.

6. Being an athlete, adequate fluid intake is very important. Explain this to Susan. Your Answer: Being an athlete required a lot of fluid because staying adequately hydrated can help reduce muscle fatigue and reduce the risk of injury. As athletes exercise, the core body temperature rises. staying hydrated replaces the water lost through sweating and is essential for hermoregulation which helps to prevent cramps, heat exhaustion and heat stroke. 6. Being an athlete, adequate fluid intake is very important. Explain this to Susan. (Perspiration is the body’s mechanism to prevent overheating. When we sweat, fluid is being released through skin pores and then evaporates. This process requires energy which in turn expends heat from the body and prevents the body temperature from rising) As a nurse, you oversee the Health Clinic at a local college. Today you are conducting physicals on the soccer team members. Susan admits that she has been feeling very tired lately. You decide to investigate further. Upon examining Susan, you note that she appears to be pale, and, in addition to feeling tired, she always seems to be cold. A urine sample is provided, and blood work is done. A dietary assessment is also completed. Breakfast: 2 slices wheat toast with peanut butter banana 6 oz coffee, black Lunch: Dinner plate filled with salad. This includes spinach, cucumbers, carrots, tomatoes 3 tablespoons of Italian dressing