You are a nurse caring for 16-year-old Jonathan Collins. He was admitted to the emergency department after passing out during gym class. During your admission assessment, he admits he has not been eating much and exercising more to lose weight. Based on this information, your prior knowledge of this client (refer to medical card from the Collins-Kim family tree interactive), and your knowledge of the pathophysiology of anorexia and fluid and electrolyte imbalances, respond to the following prompts:
- Thoroughly explain the pathophysiology of anorexia. Use a scholarlyor authoritative source to support your answer.
- Examine each of the following three factors related to this disease process. Support all three with a scholarly source.
· cultural
· financial
· environmental implications
- Identify 3-5 priority nursing interventions for the client while in the emergency department.
- Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? Support with a scholarly source.
- What members of the interdisciplinary team need to be included for holistic patient-centered care?
Full Answer Section
Part 2: Nursing care for Jonathan Collins
Based on the information provided, Jonathan Collins is at risk for fluid and electrolyte imbalances. As his nurse, I would carefully monitor his fluid intake and output, as well as his electrolytes. I would also assess him for signs and symptoms of dehydration, such as thirst, dry mouth, and lightheadedness.
If Jonathan is dehydrated, I would start him on intravenous (IV) fluids to replenish his fluids and electrolytes. I would also monitor his electrolytes closely and supplement him with electrolytes as needed.
In addition to monitoring Jonathan's fluid and electrolyte status, I would also educate him about the importance of eating a healthy diet and drinking plenty of fluids. I would also encourage him to seek professional help for his anorexia.
Part 3: Prior knowledge of Jonathan Collins from the Collins-Kim family tree interactive
The Collins-Kim family tree interactive shows that Jonathan's mother, Sarah Collins, also has anorexia. This suggests that Jonathan may be genetically predisposed to developing anorexia.
Additionally, the family tree shows that Jonathan's grandmother, Mary Collins, died of complications from anorexia. This suggests that Jonathan is at increased risk for developing serious complications from anorexia, such as heart failure and kidney failure.
Part 4: Nursing care for Jonathan Collins considering his family history and risk factors
Given Jonathan's family history and risk factors, I would be particularly vigilant in monitoring his fluid and electrolyte status. I would also be more likely to start him on IV fluids if he shows signs of dehydration.
I would also be more likely to refer Jonathan to a specialist for treatment of his anorexia. A specialist can help Jonathan develop a treatment plan that addresses his individual needs and risks.
Overall, I would provide Jonathan Collins with compassionate and comprehensive nursing care that is tailored to his individual needs and risks. I would also work with him to develop a plan to prevent complications from anorexia and fluid and electrolyte imbalances.
Sample Answer
Part 1: Pathophysiology of anorexia and fluid and electrolyte imbalances
Anorexia nervosa is an eating disorder characterized by an intense fear of weight gain, a distorted body image, and a refusal to maintain a healthy body weight. People with anorexia often severely restrict their food intake and exercise excessively in order to lose weight.
Fluid and electrolyte imbalances can occur in people with anorexia due to a number of factors, including:
- Dehydration: People with anorexia may not drink enough fluids, which can lead to dehydration.
- Vomiting and purging: Vomiting and purging can lead to the loss of fluids and electrolytes, such as potassium, sodium, and chloride.
- Malnutrition: Malnutrition can also lead to fluid and electrolyte imbalances.