Nursing Care of the Child with a Cognitive or Mental Health Disorder
Karen is a 15 years old girl who comes to the school nurse regularly with abdominal pain and constipation. After looking over her records for the past 2 years, you notice that Karen has lost 16 pounds, but she is constantly complaining that she is overweight. You notice that she runs on the track for over an hour every afternoon. Karen tells you she hasn’t had her menstrual period in over 6 month. Her body temperature is 97.9 F, her pulse is 63, and her blood pressure is 86/56. (Learning Objectives 1, 2, 3, 6)
1. What do you think Karen’s problem is? Why?
2. Discuss nursing interventions for Karen.
Suggested answers to Case Study,
Chapter 51: Nursing Care of the Child with a Cognitive or Mental Health Disorder (Pearson)
1. Karen is likely to have anorexia nervosa. Findings that validate the diagnosis are:
Ø Female gender
Ø Abdominal pain
Ø Lost 16 pounds recently
Ø Complains of being overweight
Ø Runs on the track daily for over an hour
Ø Hasn’t had a period in over 6 months
2. Nursing interventions for Karen are to make an appointment with her fa1nily doctor.
She should have some baseline labs drawn. Her weight should be monitored and she should gain 0.5 to 2 pounds per week. She should have a consultation with a nutritionist. Her vital signs should be regularly monitored, which could be done at the school clinic. She should keep a journal of ‘her food intake and l1er exercise. She should be referred to a therapist for individual group therapy. She and her family should be referred to a support group such as the Academy for Eating Disorders or the National Eating Disorders Associatio