Introduction
Bulimia Nervosa is an eating ailment caused by uncontrollably eating large amounts of food and then using unsafe methods to eliminate excess calories. Notably, the disorder is more prone to females than male teens. Jessica Johns, who has lived with her mother Marie since her two brothers live overseas in the UK and USA, was first diagnosed with Bulimia Nervosa when she was sixteen. Jessica, now eighteen years old, has been working in a logistics company as a receptionist since she deferred to join the university. Lately, Jessica’s behaviors started changing during the last six months, when she has been displaying strange behaviors, such as preferring to eat alone and avoiding people at mealtimes. Jessica has been more antisocial and withdrawn and would return to the bathroom after eating. Due to the unusual changes in Jessica’s routines, she was taken to a General Practice nurse who referred her to a hospital.
Case Analysis
Jessica was admitted to a cardiac unit for cardiac monitoring and treatment of hypokalemia. Her serum potassium concentration was <2.5 mEq/L, which is below the normal range of 3.5–5.0 mEq/L. The low level is dangerous since it can result in abnormal heart rhythms, fatigue, and muscle cramps. Hypokalemia is caused by diarrhea, low intake of potassium in the diet, and vomiting. Bulimia nervosa patients would force themselves to vomit to get rid of the excess calories. In vomiting, one gets rid of essential potassium ions necessary for maintaining stable potassium ion concentration in the body. Since the condition has troubled Jessica mentally, the mental health practitioners performed a SCOFF questionnaire to review her health status (Ossenber et al., 2020). Jessica has been submitted to treatment, though she seems uncomfortable with the decision, making her less willing to comply.
Based on the scenario presented above, the priority for Registered Nurses when managing Jessica’s situation would be to ensure that she receives evidence-based patient care to improve her condition. In particular, nurses would focus on providing care based on the latest scientific evidence and best practices (Jacobs et al., 2018). This would include ensuring Jessica receives the appropriate medications and treatments and monitoring her condition closely to ensure that it does not worsen. Additionally, nurses would educate and support Jessica and her family members to help them cope with her condition and make the necessary lifestyle changes (Driscoll et al., 2019). The study aims to outline practices that RN should prioritize when handling patients with acute and chronic conditions like Jessica’s. Such practices include Recognising and diagnosing the condition, Investigating the condition, Treating the condition, Rehabilitating the patient, Preventing the condition from recurring, educating the patient, and monitoring the condition.
Discussion
Evaluate how effective the actions taken in the course of the patient’s treatment process are. All the other components are biased and depend on a variety of circumstances. The only evaluation that will show the importance of the nurse’s influence in the treatment process is the patient’s recovery. Then, the fact of how necessary and accessible the treatment became clear. In addition, the specific observations that would be made of her would include her vital signs, weight, and height (Driscoll et al., 2019). The outcomes would be referred to depict whether she suffered from complications such as hypokalaemia, hypernatraemia, and any cardiac arrhythmias (Jacobs et al., 2018). Her vital signs would be monitored closely, and her weight and height would be measured to calculate her body mass index.
The care plan for Jessica should focus on three main areas: her physical health, her mental issues and her eating disorder. Regarding her physical health, the main goal should be to correct her electrolyte imbalance and stabilize her heart rate (Morris & Atkinson, 2018). Regarding her mental health, the primary goal should be to help her cope with her feelings of regret, guilt, and shame (Ossenberg et al., 2020). As with any nurse, when confronted with a problem, it is necessary to establish the root of the problem and provide all possible services to help improve the patient’s condition. In the case of bulimia, it is essential to provide not only an initial examination and observation but also the help of a psychologist. Often, a mental health professional is required because, with the proper morals, one can guide the patient by acting on his subconscious mind (Australian College of Mental Health Nurse, 2013). The nurse must provide a specialist and accompany the patient in recovery.
After assessing Jessica’s problem and developing a strategic care plan, the RN should administer hypokalaemia and hypernatraemia treatment. In essence, the RN should give Jessica potassium supplements and continuous cardiac monitoring, refer Jessica to a dietician, and ensure she gets enough fluids. In addition, the RN should ensure that Jessica is on bed rest with supervised toilet privileges before meals and 1 hour after meals and that she has 1:1 nursing (Driscoll et al., 2019). Referral to a dietician will help to ensure that Jessica is getting the proper nutrition that she needs, and the supervised toilet privileges will help to prevent her from purging or using laxatives. Finally, the 1:1 nursing will help ensure that Jessica gets the care and attention that she needs.
To guarantee Jessica’s successful treatment process, the application of specific nursing standards, code of conduct, code of ethics, and legalities must be made. Such nursing standards include the standards of care for managing hypokalaemia and hypernatraemia, the standards of care for managing cardiac arrhythmias, and the standards of care for managing eating disorders (Daly, 2018). The code of conduct for nurses is relevant as it sets out the professional standards nurses must adhere to. It is also worth understanding that in the medical field, the key concept is the morality of choice made. Each employee should be guided by what results from it will lead to, not only now but also in the future. It is also worth noting that it is about human health and life, and these values are essential not only in health care but also in everyone’s social life. Often, these principles go against the principles of legal norms, as their application in the treatment process can lead to harmful consequences in the future. That is why it is essential to start from the condition of the patient but also from the requirements of current medicine.
The relevance of contemporary nursing practice is unchanged and at the same high level as before. It is now only possible to imagine life with quality treatment and care for the individual because these standards have stayed the same after a great deal of time and are fundamental in this branch (Nursing and Midwifery Board of Australia, 2016). The same goes for cultural designation because all patients are individuals who need a different approach (Department of Health Victoria, 2014). Often there are significant cultural differences between people and in order for the patient to feel comfortable, it is necessary to be aware of ethnic and not only ethnic differences.
The RN can apply a patient-centered care approach to focus on Jessica as an individual and her specific needs. This approach would involve creating a care plan tailored to her situation and working closely with her to ensure that she complies with her treatment plan. A recovery-oriented approach would focus on helping Jessica to recover from her eating disorder and laxative abuse. This would involve working with her to establish healthy eating habits and helping her overcome any psychological barriers preventing her from recovery. A trauma-informed approach would focus on the fact that Jessica has a history of trauma and abuse (Tebes et al., 2019). This approach would involve working with her to address any unresolved trauma and helping her to develop healthy coping mechanisms (Jacobs et al., 2018). Ultimately, the most important thing is ensuring Jessica receives the care and treatment she needs to recover from her eating disorder and laxative abuse. An example of this method would be any influence on a subsonic activity that resulted in a positive outcome. This includes conversation, which is also capable of changing people’s lives through indirect influence.
Conclusion
It is fundamental to note that patients with irregular vital signs should be immediately referred to an experienced doctor for further assessment. Jessica’s low blood pressure, irregular pulse, and feeling dizzy at times were indicative of an underlying cardiac condition. After being admitted to the cardiac unit, her potassium levels were found to be low, and she was also suffering from hypernatremia. These electrolyte abnormalities can lead to cardiac arrhythmias, which can be life-threatening. Therefore, Jessica needed to be closely monitored and treated for her hypokalaemia and hypernatraemia (Daly, 2018). In addition, her history of binge eating, purging, and laxative abuse put her at risk for developing eating disorders, which can be life-threatening. As such, the Mental Health Team was consulted, and a care plan was developed that included potassium supplements, continuous cardiac monitoring, referral to a dietician, and supervision at all meals. Although Jessica was initially angry at the rules and plan of care, she eventually accepted them and complied with the treatment plan.
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