Case Study 130
You are a nurse on an inpatient psychiatric unit. J.M., a 23-year-old woman, was admitted to the psychiatric unit last night after assessment and treatment at a local hospital emergency department (ED) for “blacking out at school.” She has been given a preliminary diagnosis of anorexia nervosa. As you begin to assess her, you notice that she has very loose clothing, she is wrapped in a blanket, and her extremities are very thin. She tells you, “I don't know why I'm here. They're making a big deal about nothing.” She appears to be extremely thin and pale, with dry and brittle hair, which is very thin and patchy, and she constantly complains about being cold. As you ask questions pertaining to weight and nutrition, she …show more content…

Explain your answers. Clinical symptoms of malnutrion, dehydration, electrolyte imbalance, and hypothermia all have highest priority and need to return her to homeostasis as soon as possible.

CASE STUDY PROGRESS J .M.'s ECG results show normal sinus rhythm with no ST segment or other changes. You meet with J.M. to formulate a plan of care. 9. In general, the care plans for patients with anorexia are detailed and include many psychological aspects. What are they? You should be able to name at least 10.
Distorted body image
Self-evaluation based largely or entirely in terms of weight and appearance
Pre-occupation or obsessive thoughts about food and weight
Refusal to accept that one’s weight is dangerously low despite warnings from family, friends and/or health professionals
Low self esteem
Mood swings
Clinical depression
Withdrawal from interpersonal relationships in favor of social isolation
Disturbed personality image
Spiritual distress
Defensive coping
Disturbed thought process
Ineffective denial
Social Isolation
Impaired social interactions
Disabled family coping
Fear

10. What would indicate successful treatment with J.M.?
Establish adequate nutritional intake, correct fluid and electrolyte imbalances, development of realistic body image, develop support network and could possibly include family and other groups, understanding that treatment regimen and why it’s in place, plans to place to meet needs after discharge date, and weight gain with a tolerance