Scenario Diagnosis Bulimia Nervosa and self harm Case Summary 28-year-old man with exacerbated depre. Question
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Asked by MSBKhaLeeloo
Scenario
Diagnosis
Bulimia Nervosa and self harm
Case Summary
28-year-old man with exacerbated depressive anxiety, Bulimia Nervosa and self harm
Clinical Findings
Evidence of repeated vomiting (poor dentition)
Evidence of self harm (multiple lacerations on upper extremities)
Poor eye contact
Technical Skills
Assessment
Full set of vital signs
Establish a history of the presenting complaint
Establish recent history of vomiting
Establish medical history & psychiatric history
Establish medication history and allergy status
Identify social history including sources of support
Perform focused physical exam
Identify evidence of self harm (skin exam)
Identify poor dentition (mouth exam)
Initial Investigations
Perform EKG
Perform capillary blood glucose
Draw blood tests
Perform and interpret eating disorder screen (SCOFF score)
Management
Institute environmental safety measures
Monitor vital signs
SBAR report to attending
Non-technical Skills
Make appropriate, timely clinical decisions
Effectively communicate with patient
Effectively manage your team
Maintain patient safety and comfort
Seek advice from appropriate colleagues (senior medical support and psychiatric team)
What are the main concepts relevant to the patient scenario listed above? Please provide rationales and supporting evidence including course textbook and scholarly references.
What are the normal and abnormal signs and symptoms you should recognize in the patient? What are the steps you can take in your assessment of the patient? What would be your potential findings? Based on your findings, how would you prioritize the care of the patient? Please provide rationales and supporting evidence including course textbook and scholarly references
Based on the assessment findings, what would your independent nursing interventions? (Nursing interventions do not require a provider’s order). Please provide rationales with supporting evidence including course textbook and scholarly references. What specific steps would you take to improve the patient’s outcome?
What would some Related Concepts be? Identify at least 5
Example-main concept of tissue integrity; if tissue integrity is altered/impaired what would be the impact on other concepts such as nutrition, mobility, elimination, perfusion, thermoregulation OR if there is an alteration in nutrition, mobility, elimination, perfusion, or thermoregulation how would that impact tissue integrity?
What would some Related Assessments be? Identify at least 5
Example – main concept of tissue integrity; wound assessment to include location, color, size, shape, odor, and drainage. Report your assessment findings-the patient has a 2cm oval wound on the L heel. The wound is red in color, has no odor, and is producing a scant amount of serous drainage. The wound edges are defined, and the surrounding tissue is pink and warm with no edema.
What would some Related Nursing Interventions be? Identify at least 5. An intervention is defined as “any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance patient/client outcomes” (Butcher, Bulechek, Docterman, & Wagner, 2018, p.xii).
Example-main concept of skin integrity: reposition the patient at least every two hours or more frequently if needed. Place a rolled sheet or blanket underneath the ankles to reduce the pressure of the heels against the bed, use pillow or cushions to pad other bony prominences to prevent future pressure ulcers from occurring.
SCIENCE
HEALTH SCIENCE
NURSING
BSN 266
Scenario Diagnosis Bulimia Nervosa and self harm Case Summary 28-year-old man with exacerbated depre
