Lindsay Smyth Lindsay Smyth, a 15 year old young woman, was admitted by her pedi
ID: 124180 • Letter: L
Question
Lindsay Smyth Lindsay Smyth, a 15 year old young woman, was admitted by her pediatrician for evaluation. Her parents, who are divorced, came with her to the hospital. The client lives with her mother and has no siblings. She has no past psychiatric history or other medical problems. Her pediatrician and her parents report that the client has lost 40lbs in the past year. Despite this weight loss, she has continued to go to school and to excel academically. She also jogs 2 hours every day regardless of the weather conditions. The client has a limited social life. The client is an underweight 15 year old. She is 5ft, 4in tall and weighs 90lbs. She carefully removes her shoes, socks and all outer clothing prior to weighting. She is most concerned about the accuracy of the scale. The client denies dizziness or seizures. Sometimes she has constipation. She has not had her period in 5 months, but she is not concerned about this change. Upon physical examination, her hands and feet are cold and dry with lanugo on her legs. The client is defiant during the assessment interview. When she is asked to describe herself, she says that she is overweight. When asked about her typical diet, she responds, “its normal.” She would give no details about her diet. The client wears a large shirt that hangs down to her knees. During the interview, she tells you that she must unpack and will not answer questions unless she can unpack. You notice that she carefully arranges all of her clothing and personal items. When you interview her mother and father, they say that their daughter will not talk about her weight loss with them. Her mother is well dressed and thin. She was unaware that her daughter had not had a period for 5 months. The client sees her father once a month. Both parents say that their daughter must have a physical problem that is causing the weight loss. In addition they think exercise is important, and they both participate in daily exercise programs. After the client’s first day in the hospital, she has only been out of her room as required. She has not been eating but has been drinking water and orange juice at specific times. When you found her exercising in her room she refused to stop. The treatment team is meeting to plan further assessments, laboratory testing and treatments. Her admission diagnosis is anorexia nervosa. The client’s diagnostic findings are as follows: Vital signs: Blood pressure 100/70, Respirations 20, Oral temperature 37.3 C, Heart rate 82 bpm Hematology: RBC 3.5, Hgb 100 g/L, Hct 32%, WBC 4000 Urine drug screen: Negative for illicit drugs
QUESTIONS
1. Discuss 4 factors that place the client at risk for developing an eating disorder. (4 marks)
2. What data supports the inference that the client is suffering from an eating disorder? (2 marks)
3. How are anorexia nervosa and bulimia different? (2 marks)
4. What is the relationship between body image, need for control and eating disorders? How does this apply to the case study? (2 marks)
5. Develop 4 client outcomes you would want the client to achieve before discharge and discuss the importance of each. (6 marks)
6. Discuss 4 priority nursing interventions that should be considered to assist the client with discharge. (6 marks)
7. How may your own biases regarding adolescents and eating disorders impact your ability to provide care? Discuss three of your biases. (3 marks)
Explanation / Answer
1. FOUR RISK FACTORS THAT CAN LEAD TO EATING DISORDER.
a) The fact that she thinks that she is overweight can cause self consciousness and she may end up dieting which can lead to anorexia.
b) As her mother is thin and well dressed she may compare herself with her mother which again leads her to dieting.
c) Since the client has a limited social life she may be a victim of bully, feeling of shame and guilt may have caused eating disorder.
d) The schools also encourages more of foods which include vegetables and less sugar and gluten, this could also trigger client and may lead to anorexia.
2. DATA WHICH SUPPORTS THAT CLIENT IS SUFFERING FROM EATING DISORDER.
a) History : When the pediatrician asked about herself the client replied that she is overweight.
b) Physical examination : During physical examination when the weight was being checked the client removed all her outer clothing which could any of which could increase the weight in the machine.
c) She jogs for 2 hours daily no matter what the weather is.
d) Finding client exercising in the room and does not stop even if we see her.
e) Drinking only water and orange juice in specific time.
3.DIFFERENCE BETWEEN ANOREXIA NERVOSA AND BULIMIA NERVOSA.
ANOREXIA NERVOSA : Anorexia is a condition in which self starvation is seen with loss of weight and usually are thin.
BULIMIA NERVOSA : Whereas, Bulimia nervosa is a condition very similar to anorexia nervosa but they tend to have average weight or overweight.
4. RELATIONSHIP BETWEEN BODY IMAGE, NEED FOR CONTROL AND EATING DISORDER, APPLICATION TO CASE STUDY :
a) Social media is the largest platform where they have created the image of an ideal body and usually model who are thin and skinny are showcased, this could have a worst impact on teenagers or the girls all around the world. Because of such wrong message conveyed to the people it leads to feeling of uncontrolled self consciousness and people go on a diet sometimes they cannot do it but for some it can lead to eating diorders like anorexia nervosa and bulimia nervosa.
How the relationship between this could be applied in the case study is this would be really helpful to find out the causes and the sources of such conditions which is very important inorder to plan out the treatments or the preventions.
5. 4 CLIENT OUTCOMES TO ACHIEVE BEFORE DISCHARGE.
a) Maintain ideal weight : Maintaining ideal weight is very important as the client is in growing stage she need proper nutrition.
b) Maintain good communications : Client should be able to communicate with her parents to share about things. Good communications is very important.
c) Socialise more : Client will be able to socialise more and make new friends as its always good to have someone to share your problems if not comfortable with the parents.
d) She will be more confident : The client will be more confident about herself and accept herself the way she is.
6. 4 PRIORITY NURSING INTERVENTIONS :
a) Encourage her to follow a healthy diet and explain her the importance and benefits of healthy diet.
b) Explain her the importance of good communications.
c) Encourage her to socialise with the people.
d) Explain her the the diagnosis.
7. BIASES REGARDING ADOLESCENTS AND EATING DISORDER :
a) If such case happens I would not provide a good care as I will simply not entertain.
b) I would not provide much attention to it as for a 15 year old, according to me is too early to think about being overweight.
c) I may compare her with the people who really dont have food to eat and are dieng because of starvation and not because they want to become thin or slim.
Related Questions
drjack9650@gmail.com
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.