lOMoARcPSD|3013804
Electrolyte Imbalance Keith
RN
Advanced Adult Health Care (Keiser
University)
, lOMoARcPSD|3013804
Eating Disorder/Electrolyte Imbalances
Mandy White, 16 years old
Primary Concept
Fluid and Electrolyte Balance
Interrelated Concepts (In order of emphasis)
1. Acid-base
2. Nutrition
3. Perfusion
4. Coping
5. Mood and Affect
6. Clinical Judgment
7. Communication
8. Collaboration
9. Patient education
© 2016 Keith Rischer/www.KeithRN.com
, lOMoARcPSD|3013804
UNFOLDING Reasoning Case Study: STUDENT
Eating Disorder/Electrolyte Imbalances
History of Present Problem:
Mandy White is a 16-year-old adolescent who has struggled with anorexia nervosa since the age of 11. She admits to
drinking several large glasses of water daily. Mandy has also been recently engaging in self injurious behavior (SIB) of
cutting both forearms and thighs with broken glass, causing numerous lacerations and scars.
Mandy presents to the emergency department (ED) with increasing weakness, lightheadedness and a near syncopal
episode this evening. She admits to inducing vomiting after meals the past three weeks. She is 5’ 5” and weighs 83
lbs/37.7 kg (BMI 13.8). Mandy is reluctantly brought in by her mother and does not want to be treated. As the primary
nurse responsible for the care of Mandy, you overhear her say to her mother, “I hate everything about me! I am so tired
of living, I wish I were dead!”
Personal/Social History:
Mandy was sexually abused by her stepfather from the age of six to twelve. She confided what was taking place to her
mother and lives with her mother, who is now divorced. Mandy is sexually active and promiscuous. She uses the Tinder
app to meet older men for anonymous sexual encounters when her mother is working.
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Struggles with anorexia nervosa since 11. Patient is suffering form depression, hopelessness,
Engaging in self injury behavior cutting habits. underweight and sucidal behaviors.
Came to ED with weakness, lightheadedness,
syncope, inducing vomitingfor three weeks,
BMI 13.8, reluctant to be seen, states " I hate
everything about me! I am so tired of living, I
wish I was dead!"
RELEVANT Data from Social History: Clinical Significance:
Sexually abused by step-father from Truama from past situations has altered Mandy's childhood.
age 6-12, mother also expreicened Needs psychiactric evaluation.
some type of abuse and is now
divorced. Sexually active and
promiscuous, uses dating apps.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
Anorexia nervosa Citalopram 20 mg PO daily Antidepressants Used to treat
Depression depression.
Self-injurious behavior (SIB)
Sexually abused as a child
What medications treat which conditions?
Draw a line to identify what illness is being managed by what medication?
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology, (if applicable), which disease likely developed FIRST that created a “domino effect” in his/her
life?
Circle what PMH problem likely started FIRST.
Underline what PMH problem(s) FOLLOWED as domino(s).
© 2016 Keith Rischer/www.KeithRN.com
Electrolyte Imbalance Keith
RN
Advanced Adult Health Care (Keiser
University)
, lOMoARcPSD|3013804
Eating Disorder/Electrolyte Imbalances
Mandy White, 16 years old
Primary Concept
Fluid and Electrolyte Balance
Interrelated Concepts (In order of emphasis)
1. Acid-base
2. Nutrition
3. Perfusion
4. Coping
5. Mood and Affect
6. Clinical Judgment
7. Communication
8. Collaboration
9. Patient education
© 2016 Keith Rischer/www.KeithRN.com
, lOMoARcPSD|3013804
UNFOLDING Reasoning Case Study: STUDENT
Eating Disorder/Electrolyte Imbalances
History of Present Problem:
Mandy White is a 16-year-old adolescent who has struggled with anorexia nervosa since the age of 11. She admits to
drinking several large glasses of water daily. Mandy has also been recently engaging in self injurious behavior (SIB) of
cutting both forearms and thighs with broken glass, causing numerous lacerations and scars.
Mandy presents to the emergency department (ED) with increasing weakness, lightheadedness and a near syncopal
episode this evening. She admits to inducing vomiting after meals the past three weeks. She is 5’ 5” and weighs 83
lbs/37.7 kg (BMI 13.8). Mandy is reluctantly brought in by her mother and does not want to be treated. As the primary
nurse responsible for the care of Mandy, you overhear her say to her mother, “I hate everything about me! I am so tired
of living, I wish I were dead!”
Personal/Social History:
Mandy was sexually abused by her stepfather from the age of six to twelve. She confided what was taking place to her
mother and lives with her mother, who is now divorced. Mandy is sexually active and promiscuous. She uses the Tinder
app to meet older men for anonymous sexual encounters when her mother is working.
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Struggles with anorexia nervosa since 11. Patient is suffering form depression, hopelessness,
Engaging in self injury behavior cutting habits. underweight and sucidal behaviors.
Came to ED with weakness, lightheadedness,
syncope, inducing vomitingfor three weeks,
BMI 13.8, reluctant to be seen, states " I hate
everything about me! I am so tired of living, I
wish I was dead!"
RELEVANT Data from Social History: Clinical Significance:
Sexually abused by step-father from Truama from past situations has altered Mandy's childhood.
age 6-12, mother also expreicened Needs psychiactric evaluation.
some type of abuse and is now
divorced. Sexually active and
promiscuous, uses dating apps.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
Anorexia nervosa Citalopram 20 mg PO daily Antidepressants Used to treat
Depression depression.
Self-injurious behavior (SIB)
Sexually abused as a child
What medications treat which conditions?
Draw a line to identify what illness is being managed by what medication?
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology, (if applicable), which disease likely developed FIRST that created a “domino effect” in his/her
life?
Circle what PMH problem likely started FIRST.
Underline what PMH problem(s) FOLLOWED as domino(s).
© 2016 Keith Rischer/www.KeithRN.com
