Question

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

question:

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)

Answer 1

1. Discuss 4 factors that place the client at risk for developing an eating disorder. (4 marks)

• Client has lost 40lbs in the past year: losing 40 lbs in a year is a matter of concern. She keeps her weight a secret and she thinks her diet is normal.
• She has not had her period in 5 months, but she is not concerned about this change: She is missing periods and she thinks it is normal and her parents have no idea about it.
• Her hands and feet are cold and dry with lanugo on her legs.this indicates her adipose tissues are very little and she is intolerant to cold. She keeps a long shirt to cover herself.
• She says that she is overweight and exercises even in the hospital. She tells her diet is normal, but skips food and takes only water and juice.

2. What data supports the inference that the client is suffering from an eating disorder? (2 marks)

• She thinks her diet is normal
• She thinks she is overweight
• The nurse has seen her having only water and orange juice
• She is over concerned about exercising

3. How are anorexia nervosa and bulimia different? (2 marks)

Anorexia and Bulimia are eating disorders. They may have similar symptoms and physical symptoms can be life threatening too. Both the eating disorders has one cause as distorted body image.

People with anorexia nervosa will try to reduce the food intake in order to reduce the body weight and maintain body shape. They may find dieting and weight loss as method of control to their lives.

People wit Bulimia will eat a lot of foods in a short duration of time and then induce vomiting or administer other methods to avoid weight gain. They may use diuretics, cathartics, laxatives etc as a method of removing the food out of the body. They rely on over exercising in order to reduce weight.

4. What is the relationship between body image, need for control and eating disorders? How does this apply to the case study? (2 marks)

Negative body image is a potential contributor of eating disorder. The people with such disorder, usually place a high value on their body shape and weight when determining self worth.

The client Lindsay smith is just 15 years old teenager, and she is socially not very active. She belongs to a broken family and lives without siblings. She may be having emotional and psychological needs unmet by her family. She may be depressed without siblings and close friends to share her troubles. Keeping up her body image, body shape will be a highlightner for her to control herself. She also has some obsessions on neat and tidy and well arranged looks. She keeps her things in an ordered way. These all point to the fact that body image and need for control is related to her eating disorder.