Kate Ebony Case Study - Nursing Assignment Help

Assignment Task

Kate Jones, aged 14, was admitted to the adolescent mental health unit at 1300 after being presented to the emergency department with a letter from her GP requesting admission due to being medically compromised, with ECG changes, pathology abnormalities including being anaemic,  and  BP and pulse irregularities.  She has been placed under the MHA.
Kate was diagnosed with anorexia nervosa 12 months ago by her GP and has been supported with community services including a private dietician and psychologist. Over the past 2 months, Kate has reduced her oral intake and increased her physical activity against the advice of her treating team. Her GP had commenced Fluoxetine and recently increased to 40mg without efficacy. Additionally she is on a multivitamin and folic acid. Collateral from mother is that Kate has been ammenorrhic for the past 6 months after reaching menarche at the age of 12.  Sleep pattern has been disturbed with initial and middle insomnia.
Kate lives with her mother in a single parent family and is the eldest of 4 children.  Her father lives in Brisbane and has infrequent contact as he has remarried and has a new baby. She is in grade 9 at a local high school and obtains A average grade in her studies. Her mother denies that there has been any trauma history.
Pathology from the GP indicated that she was anaemic; low blood sugar and albumin levels, and mild  hyponatremia and hypokalemia. 
Initially difficult to engage with the admission process, she  voiced her fear of being “fattened up” resulting in voicing suicidal ideation if she were to put weight on. Kate perceived that her stomach and thighs have too much fat on them, which results in lower self-esteem .
Her physical appearance is in keeping with a anorexia nervosa diagnoisis with cathexic appearance, low body weight at 40kg with a BMI of 14.9. Evidence of lanugo on her face and her hair is brittle. She is waering oversized and warm clothing as she cited she is feeling cold all the time, and her current temperature is 35.4.
Her judgement with resitrciting her oral intake and excessive exercising  is impaired also correlates with her lack of insight into her current physical condition and need for hospitalisation.
  Although she appears tired with some evidence of decline in her concentration, she is orientated with recall of recent and remote memory. 
Although she stated she was happy at school, other times she feels very low in her mood and more so now as she perceives that by being forced to be hospitalised she will not be able to lose more weight to achieve her goal weight of 38kg, and has voiced suicidal ideation.
Kate’s current risk is low for  violence and aggression, , and moderate for suicide / self harm,and vulnerability  as she is also at risk of sabotaging her meal program due to her impaired decision making.  Due to this, the RMO has ordered constant observations especially at meal times and up to 60 minutes post meals. 
Being under the MHA, daily review by the registrar or consultant, and daily risk assessments. 
The medical officer has requested daily weighing, ECG’s and BSL and 4/24 physical observations with sitting and standing P and BP measures, along with daily pathology.  
 

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