Read the scenario below and use it to answer the questions below:… Read the scenario below and use it to answer the questions below: You are a nurse on an inpatient psychiatric unit. E.B, an 18-year-old high school senior was admitted to the unit after being seen in the Emergency department yesterday afternoon following a fainting episode at school. She has been given a diagnosis of anorexia nervosa and depression. As you begin to assess her you notice she is wearing very loose clothing, 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, I just got lightheaded for a second.” She appears to be extremely thin and pale, with dry brittle hair, which is very thin and patchy, and she constantly complains about being cold. As you complete her admission assessment you find out that E.B lives with her mom and new stepdad, is a straight A student, plays the flute in the school band and is a cheerleader for the high school football team. E.B tells you that her and her boyfriend recently broke up because they plan to attend college in different states and “don’t want the hassle of a long-term relationship.” As you question E.B about weight and nutrition she becomes defensive and vague but does admit to losing “some” weight after an appendectomy 2 years ago. She tells you that she used to be fat, but after losing weight following the surgery everybody started commenting on how good she was beginning to look so she just quit eating for a while. She informs you she is eating “lots” now, even though everyone keeps “bugging me about my weight and how much I eat.” She eventually admits to a weight loss of “about 50 pounds, and I’m still fat.” After 2 weeks, E.B. has gained 6 pounds and has developed a healthier mind set in relation to food and body image. She still expresses fears of “getting fat,” but states she is ready to go home and back to school. The provider arranges for E.B. to participate in an outpatient therapy program that specializes in eating disorders. E.B. expresses interest in meeting others with the same problems. Questions:Identify 8 clinical signs or symptoms of anorexia nervosa. Bold and underline the signs and symptoms E.B is displaying. Explain how bulimia nervosa differs from anorexia nervosa?Name 5 behaviors that E.B. or any other patient with anorexia may engage in other than self-starvation.Your assessment of E.B reveals some risk factors associated with anorexia nervosa. Identify all the actual and potential risk factors E.B has in regards to anorexia nervosa. Upon admission to the unit the health care provider ordered lab work to be completed. The following are E.B’s lab results. Are any of these lab results concerning, if so why? What might have caused each of the abnormal values? Lab ValueResultSodium133Potassium3.4Blood Urea Nitrogen18Creatinine1.0Hemoglobin10Hematocrit36%6. Which of these are appropriate nutrition interventions for E.B? Discuss food choices with her. Allow her to eat alone during mealtimes. Allow her to select her menu on her own. Weigh her each morning after voiding, with her back to the scale. Restrict her from returning to her room or a restroom without staff supervision after meals. 7. Identify at least two different classes of medications that may be prescribed to help in the resolution of E.B’s anorexia and depression? Why/how would these medications be beneficial? 8. Which statements by E.B would indicate her treatment in the psychiatric unit has been successful? “I just have to stay skinny to feel good.” “When you say I look ‘healthy’ I feel fat.” “Lately I’ve been feeling a little better about things.” “I am looking forward to going out with my friends again.” “It’s up to me to take care of my body by eating enough food.” Health Science Science NursingShare
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