J.M.'s eCG results show normal sinus rhythm with no stsegment or other changes. you meet with J.M. to formulate a plan of care
Name at least four nutritional interventions.
List at least six psychological aspects of the plan of care for J.M.
Question 2You review her admission laboratory studies. an electrocardiogram (eCG) has also been ordered.
Admission Lab Work
Sodium 135mEq/L
Potassium 3.4mEq/L
Chloride 99mEq/L
Magnesium 1.5mEq/L
Bloodureanitrogen 18mg/dL
Creatinine 1.0mg/dL
Hemoglobin 11g/dL
Hematocrit 35
Which laboratory results might be of concern at this time? Explain your answers.
What clinical symptoms of anorexia nervosa, if present, should have the highest priority?
Explain your answers.
Question 3You are a nurse on an inpatient psychiatric unit. J.M., a 23-year-old woman, was admitted to the psychiat-ric unit last night after assessment and treatment at a local hospital emergency department 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 has very loose clothing, she 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. she appears to be
extremely thin and pale, with dry and brittle hair, which is very thin and patchy, and she constantly com-plains about being cold. as you ask questions pertaining to weight and nutrition, she becomes defensive
and vague, but she does admit to losing some weight after an appendectomy 2 years ago. she tells you
that she used to be fat, but after her surgery she didn't feel like eating and everybody started comment-ing on how good she was beginning to look, so she just quit eating for a while. she informs you that 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 40 pounds and I'm still fat.
Using Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition (DSM-V) criteria,
how is the diagnosis of anorexia nervosa determined?
Identify eight clinical signs or symptoms of anorexia nervosa. Place a star or asterisk next to
those that J.M. has.
What other disorders might occur along with anorexia nervosa? Name at least four.
How does bulimia nervosa differ from anorexia nervosa?
Name five behaviors that J.M. or any other patient with anorexia may engage in other than
self-starvation.
What common family dynamics are associated with anorexia nervosa?
Question 4As you go in to give R.B. his medication, he speaks to you in fragmented sentences. Is that a bird? the little flowers jump up and down. What says the moon?
Before you can say anything, he asks, do you see
that bird over my bed? she is telling me not to leave this room. If I move she will swoop down and try to
peck at my eyes. Be careful
Is he having a delusion or a hallucination? Explain your answer.
Which responses by the nurse are appropriate? Select all that apply.
a. I don't see a bird over your head, but I can understand how that would be upsetting to
you.
b. There is no bird over your bed.
c. Tell me more about what you are seeing.
d. The voice you are hearing is part of your illness. It can't hurt you.
e. I'll come back to talk to you when you are settled down.
Question 5R.B. is started on olanzapine (Zyprexa). you inform R.B. and his family about the common side effects of the atypical antipsychotics.
What are the common side effects of atypical antipsychotics such as olanzapine (Zyprexa)?
Select all that apply.
a. Tardive dyskinesia
b. Drowsiness
c. Dry mouth
d. Palpitations
e. Nausea
f. Weight gain