What Should the Nurse Do?
Mariela is a 19-year-old college student who has recently lost a significant amount of weight and expresses dissatisfaction with her body image. She reports engaging in restrictive eating behaviors, excessive exercise, and frequent self-criticism related to her appearance. Mariela appears anxious and avoids making eye contact during the assessment.
1
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What psychological factors might contribute to Mariela’s development of an eating disorder, based on the information provided?
2
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How do social factors, such as societal standards of beauty and peer influences, potentially influence Mariela’s perception of body image and eating behaviors?
3
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Considering physiological, hereditary, and environmental factors, what could be contributing to Mariela’s presentation of an eating disorder, and how would you rank these hypotheses in terms of likelihood?
4
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What nursing interventions would be appropriate for addressing Mariela’s identified problems related to her eating disorder symptoms?
KB is a sixteen-year-old who presents to the clinic with her mother with reports of no menses for four months. She has no past medical history and takes no medications. Her mother mentioned having the same issue at her age when she was modeling and states that her issue was caused by her extreme dieting habits. Her mother also states that she feels that KB is underweight and that she has lost twenty pounds since she had her last visit eight months ago. KB reports that she often skips meals and reports that she is on an extreme diet plan to help her look more like her favorite YouTube model who is admired for her tiny waistline. During the exam, KB has a BMI of 17.5, a heart rate of 55 beats/min, and a blood pressure of 90/50. Based on the information you have, answer the following questions:
5
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What eating disorder do you suspect KB may have and why?
6
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How does her mother’s history affect KB’s risk?
7
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What would be a priority nursing intervention for KB?
Drake, a 16-year-old, has been admitted to the pediatric unit of a hospital for evaluation and treatment of disordered eating behaviors. Drake presents with significant weight loss, extreme food avoidance, and nutritional deficiencies. Upon assessment, it becomes evident that Drake’s eating patterns are driven by a fear of adverse consequences associated with eating, rather than a concern about body weight or shape. The client exhibits distress or impairment in social, occupational, or other important areas of functioning due to food intake restrictions.
8
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Based on Drake’s presentation, what features differentiate their condition from anorexia nervosa?
9
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What nursing interventions could be included in Drake’s care plan to address their avoidant/restrictive food intake disorder (ARFID)?
Jamal, a 10-year-old male, has been brought to the pediatric clinic by his parents due to concerns about his eating habits. Jamal’s parents report that he frequently consumes non-nutritive, nonfood items such as paper, clay, and dirt. Despite their attempts to intervene, Jamal continues to engage in this behavior, and they are worried about potential health risks. Upon assessment, it becomes evident that Jamal’s consumption of nonfood items is not a culturally sanctioned practice and is not better explained by another psychiatric disorder.
10
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What factors might contribute to the development of pica in Jamal's case?
11
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What conditions or comorbidities should the nurse assess for in Jamal’s case, given his presentation with pica?
12
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What treatment options would be appropriate for addressing Jamal’s pica, and how would you rank these options based on his individual needs and circumstances?
13
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What nursing considerations should be prioritized when caring for Jamal and supporting him in managing his pica?