1718: Client brought to the ED by her roommate. The roommate reports that she has been experiencing dizziness throughout the day, which has worsened to where she has ‘blacked out’ for several moments prior to arrival. Three weeks ago, the client was discharged from an outpatient behavioral health facility for treatment of anorexia nervosa. On assessment, the client is drowsy but arousable by verbal command. Peripheral pulses 1+. Skin is dry and flaky. Excessive fine hair growth all over the client’s spinal column and arms. Patches of alopecia. Lung sounds are clear bilaterally. Bowel sounds are hyperactive in all four quadrants. She denies pregnancy as she has had amenorrhea for the past year. BMI 16.5 kg/m2. Medical history of anorexia nervosa.
1718: Client brought to the ED by her roommate. The roommate reports that she has been experiencing dizziness throughout the day, which has worsened to where she has ‘blacked out’ for several moments prior to arrival. Three weeks ago, the client was discharged from an outpatient behavioral health facility for treatment of anorexia nervosa. On assessment, the client is drowsy but arousable by verbal command. Peripheral pulses 1+. Skin is dry and flaky. Excessive fine hair growth all over the client’s spinal column and arms. Patches of alopecia. Lung sounds are clear bilaterally. Bowel sounds are hyperactive in all four quadrants. She denies pregnancy as she has had amenorrhea for the past year. BMI 16.5 kg/m2. Medical history of anorexia nervosa.
1810: Critical laboratory result received and read back to the lab. Potassium 2.9 mEq/l [3.5-5.0 mEq/l (mmol/l)]. The physician was verbally informed of this result at this time.
1815:
- insert two peripheral vascular access devices
- potassium chloride 40 mEq via intravenous infusion. Infuse over 4 hours
- 0.9% sodium chloride (normal saline) bolus, 1000 mL, infuse over 1 hour
- psychiatry consultation
- dietitian consultation
- transthoracic echocardiogram
- obtain medical records from previous behavioral health admission
- medication reconciliation for inpatient admission
- continuous cardiac monitoring
The client stabilizes in the medical-surgical unit and two days later is transferred to the behavioral health unit for voluntary admission for treatment of anorexia nervosa.
The nurse reviews the plan of care with the client.
➢ Click to specify if the client statement requires follow-up or indicates effective understanding.
- A. I can request discharge whenever I want because I am admitted voluntarily.
- B. I should weigh myself daily to track my progress.
- C. Psychotherapy will begin after I am discharged.
- D. I can choose whatever foods I want while I am here.
- E. Staff may open my packages without my consent.
- F. Journaling can help me process my thoughts and support recovery.
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