Question

Case Study Anorexia Nervosa

Questions 1-4

CASE STUDY ANOREXIA NERVOSA Joyce Mann is a 23-year-old female admitted to the psychiatric unit last night after assessment and treatment at a local hospital emergency room 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 is very loose clothing and is wrapped in a blanket. She tells you, "I don't know why I am here. They are making a big deal out of nothing". She appears to be extremely thin and pale, with very thin and brittle hair and constantly complaining about being cold. As you question her about her weight and nutrition, she becomes defensive and vague, but she does admit to loosing "some weight" after an appendectomy two (2) years ago. She tells you that she used to be fat, but after her surgery she did not feel like eating and everybody began to comment on how good she was beginning to look, so she just quit eating for awhile. She tells you that she is eating better now even though everyone keeps "bugging" her about her weight and how much she eats. She eventually admits to a weight loss of about 40 pounds and "I'm still fat." 1. Explain how the diagnosis of anorexia nervosa was made based on the patients presenting symptoms. State the clinical symptoms of anorexia nervosa. 2. 3. List the concomitant disorders associated with anorexia nervosa Identity a list of additional behaviors the patient may engage in that would enhance her weight loss other than self starvation. 4. List the common family dynamics associated with anorexia nervosa. 5. 6. What are the clinical symptoms that should have the highest priority? A care plan is developed for this patient which is very detailed and includes many psychological aspects. 7. List seven (7) psychological aspects you should consider when developing the care plan. Miss Mann is ready for discharge teaching and you are the nurse completing her teaching. Miss Mann states "I'll be so glad to get out of this place. I'm so fat and ugly. I can't wait to lose 10 pounds. I bet I can do that in a couple of days. I don't want to live anymore" 8. Explain the points you would discuss with the primary care provider based on Miss Mann's statement.. You report Miss Mann's statements to the primary care provider

Answer 1

1. Here in this case patient is thin and pale. Along with that she admit that she lost some weight after an appendectomy 2 years ago. Most importantly she admitted that she did not feel like eating after the surgery and she quit eating for a while. She also had a weight loss of 40 pounds. All these incidences helps us make us understood that these are the symptoms of Anorexia Nervosa. As Anorexia Nervosa is an eating disorder in which the person loses weight to the level of starvation. The methods of diagnosis of Anorexia Nervosa are as follows: 1) Complete blood test should be performed. The potassium level of the blood should be checked. A drop in level of potassium in blood or hypokalaemia is assign of anorexia nervosa 2) A urinalysis test can also be performed 3) Electrocardiograms should be checked for any abnormality in heart rhythms. Paralysis and muscle damage are also seen majorly in patients with anorexia nervosa 4) Vital signs should be monitored. Orthostatic hypotension or hypertension conditions are signs of this illness. 5) The height and weight of the patient should be checked. Abdomen should be examined along with nails and skin. 6) X-ray should be taken for checking any broken bones or stress fracture. 2. Main symptom of anorexia nervosa is extreme weight loss. As a result of changes in the body composition, patient notice significant changes in the way their body feels. They get tired more easily and feel difficulty sleeping at night and may be prone to dizziness or fainting Patients may also have symptoms of obsessive compulsive disorder with rigid and ritualistic eating behaviors. Following symptoms are usually found in patients: A) Dysrhythmias, bradycardia B) Hypotension C) Poor skin turgor and muscle tone D) Excessive hair loss and dryness E) Peripheral edema F) Cold extremities G) Dry or yellowish skin H) Headaches, sore throat I) Chronic urinary tract infections 3. Concomitant disorders that may occur along with anorexia nervosa are: A) Depression : seen in 50% of the cases B) Fears: such as fear of social interactions C) Body dysmorphic disorder: imaginable belief of defect in the body D) Substance abuse: such as alcohol E) Panic disorders F) Anxiety disorders

G) Post-traumatic stress disorder: mental disorder that develops when a person experiences traumatic event and feels anxious 4. Additional behavior changes that patient may engage in are as follows: a) Addiction to exercise or an excessive exercise b) Use of diuretics c) Use of increased laxatives in increased quantities d) Vomiting that is self-induced e) Purging f) Excessive use of emetics