Question

Tue PN 200 Fundamentals of Nursing II Case Study: Bulimia Nervosa Betty Boop is a 17-year-old female who is in the 12th grade. Today she presents to the medical clinic complaining of a three (3) week history of bloating, tiredness, muscular weakness, and ankle edema. Her throat has been sore for the past three days. After noticing significant changes in her daughter's behavior, her mother has persuaded her to see the family physician. When she was younger, Ms. Boop was of normal weight and height and ate from all food groups. Her parents divorced when she was 12 years old and has been living with her mother and younger sister. At age 13 she was 5'4" tall and weighed 125-130 pounds. She felt she could lose some weight but did not feel overweight. Ms. Boop began to exercise by jogging 30 minutes three times a week and tried out for the girls' 400 meter in track. She still participated in basketball and golf, but team sports did not bring her satisfaction of self-accomplishment. At age 15 she started reading magazine articles about Hollywood starlets and the sacrifices that they had made to stay thin and maintain an attractive body shape. B/P 115/80 P 110 Resp. 20 Temp 98.4 Ht. 5'7" Wt. 135 pounds # 1. Is this patient technically underweight, overweight, obese, or is her wight considered healthy and normal? Lab Values 135 NA 3.1 K 100 CI НСОЗ 25 BUN 16 Cr 1.0 Glucose fasting 65 Ca 8.7 Mg 0.9 Alb 2.8

Answer 1

1.Body mass index: Weight(kg)/height(m²⁾

• Weight:135 pounds=61.235kgs
• Height: 5 feet 7 inches=170.18 cm

            BMI= 21.1kg/m²    (Healthy weight)

• Weight for age percentile:37%
• Height for age percentile:24%
• Healthy BMI ranges from :17.7-24.9kg/m²
• Healthy weight for the height :51.3kgs-72.1 kgs

2.Abnormal laboratory values:

Lab tests	Abnormal range	Normal range
Mg	0.9	1.8-3
K	3.1	3.5-5.0
Fasting Glucose	65	less than 100
Alb	2.8	3.4-5.4
Hgb	10.9	12.0-15.5
Hct	29%	37%-48%
Amylase	280	Serum test:40-140:Urine24-400

3.Reasons for patient tachycardia is: Hypokalemia,Vigorous exercise,Poor diet,Hypertension.

• Tachycardia can caused due to poor blood supply to the heart muscle due to coronary artery disease, infections, hypertension, heart value disease.

4.Low level of magnesium(0.9) responsible for tiredness,fatigue,loss of appetite and nausea.

• Low level of potassium(3.1): Tiredness and fatigue are the first signs for potassium deficiency because Potassium is the mineral essential and regulate the muscle contraction,maintain healthy nerve function and regulate fluid balance in the human body.
• High level of Amylase(280) indicate pancreatitis and symptoms include nausea,frequent urination,fatigue and weakness.
• Fasting blood glucose of 65mg/dl is harm because decreased level of glucose can leads to hypoglycemia that symptoms include weakness,fatigue,Sweating.
• Low level of hemoglobin can cause usual tiredness and weakness

5.Hypokalemia (Low level of potassium) Potassium is the essential mineral for muscle contraction.A low level of potassium can make muscle weakness,muscle cramp,muscle twitch or even become paralysed and tachycardia may also develop.