What Are Some Initial Areas for Concern?
The primary things to worry about are the patient’s body weight and a request for pills. The problem with concentration is most likely associated with these issues. Medical considerations involve anemia, thyroid disease, vitamin deficiency, and substance abuse. It is necessary to calculate the patient’s ideal body weight and compare it with the present weight. The ideal body weight is a correlation between weight and stature of a child, and it helps physicians to identify when a child is underweight, overweight, or when their weight is within the norms (Burns et al., 2017). Vitamin deficiency and thyroid disorder also may present danger to the patient’s health due to the numerous side effects.
Another important thing to consider in this situation is that teenage girls have a very high disposition towards such severe diseases as anorexia or bulimia nervosa (Bühren et al., 2014; Duarte, Ferreira, Trindade, & Pinto-Gouveia, 2016). Both of these conditions may lead to serious psychiatric disorders that are reported to be the reason for high morbidity and mortality levels (Bühren et al., 2014). Complications of anorexia include obsessive-compulsive disorders, personality issues, high levels of anxiety, and mood disorders (Bühren et al., 2014). Frequently, teenage girls are dissatisfied with their bodies and are vulnerable to social disapproval (Duarte et al., 2016). Therefore, it is crucial to find the reasons for the patient’s thinness and come up with the most suitable approach to gaining normal body weight. Because psychiatric disorders may lead to suicidal attempts, it is necessary to stop the development of such a condition in the patient and make her return to a normal lifestyle as soon as possible.
What Screening Tools Can Help Lead You Closer to Your Diagnosis?
The primary test that should be made is the complete blood count (CBC). The CBC measures the patient’s red and white blood cells and platelets. With the help of this test, the physician may check whether the patient has anemia. Also, the CBC may help to identify other health problems and screen for fatigue and weakness (“What is a complete blood count?” n.d.). The next baseline screening tool is the thyroid-stimulating hormone (TSH) test. With the help of this test, it is possible to check the work of the thyroid gland. The TSH can show hyper- or hypothyroidism and detect other disorders even if the patient does not feel any symptoms (“What is a TSH test?” n.d.). Another thyroid screening tool is the thyroxine (T4) test.
Other tests that should be made include urine drug screen, urine pregnancy test, and screening for vitamin deficiency. Apart from these, an eating disorder examination questionnaire may be used to evaluate the patient’s eating habits and issues associated with them (Machado et al., 2014).
Describe 1 Health Promotion Strategy You Can Discuss with the Patient
A suggested health promotion approach is peer support. According to research, such type of managing eating disorders is rather productive (Stice, Rohde, Durant, Shaw, & Wade, 2013). Adolescents suffering from eating disorders as well as those having psychiatric issues tend to listen to their peers’ advice more likely than they would listen to their parents or other adults. Surely, such a strategy requires much preparation from the physician and dedication on the part of the peer. However, in many cases, it is the only possible approach to save a teenager from a dangerous situation in which they found themselves.
Be Sure to Address the Following in Your Plan of Care: Pharmacological and Non-Pharmacological (OTC) Interventions, Labs, Follow-Up, Teaching, and Referral
The plan of care for the patient will include a variety of activities. Only by joining the efforts of interventions, tests, education, and referral will it become possible to reach the most beneficial outcomes for the patient.
Pharmacological Interventions
Due to the complexity of eating disorders and their connection with psychiatric issues, it is recommended to prescribe topiramate and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Milano et al., 2013). High doses of SSRIs are reported to reduce anxiety associated with eating disorders.
Over-the-Counter Interventions
In the given case, it would be too dangerous and irrational to advise any over-the-counter drugs. The situation is rather serious, and detailed testing and pharmacological approaches are the only appropriate measures.
Labs
The necessary laboratory tests are the ones that were discussed in the “screening tools” section: CBC, TSH, and T4; screening for vitamin deficiency, urine drug screen, and a urine pregnancy test.
Follow-Up
It is necessary to create a plan for the next meetings at which the patient’s results will be measured and compared, and the effect of treatment will be checked. Also, during the next visits, it will be possible to discuss the results of the peer-support intervention and ask the patient about any other symptoms.
Teaching
Education techniques include instructing the patient about the possible adverse outcomes and side effects of her health condition. If tests confirm anorexia, it is crucial to explain to the teenager what drastic results her eating habits may cause. If the problem is in the thyroid gland, it is necessary to explain what effects it may have on her health, particularly, on her reproductive system.
Referral
For this patient, a referral for dietary nutrition assessment will be made. With the help of such an evaluation, the objective and subjective data on the patient’s lifestyle, medical history, and nutrient and food intake will be collected. Dietary nutrition assessment comprises four categories: biochemistry, anthropometrics, diet, and clinical evaluation. Such a referral will help to gather the most comprehensive data on the patient’s health condition.
References
Bühren, K., Schwarte, R., Fluck, F., Timmesfeld, N., Krei, M., Egberts, K., … Herpertz-Dahlmann, B. (2014). Comorbid psychiatric disorders in female adolescents with first onset anorexia nervosa. European Eating Disorders Review, 22(1), 39-44.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care (6th ed.). St. Louis, MO: Elsevier.
Duarte, C., Ferreira, C., Trindade, I. A., & Pinto-Gouveia, J. (2016). Normative body dissatisfaction and eating psychopathology in teenage girls: The impact of inflexible eating rules. Eating and weight disorders, 21(1), 41-48.
Machado, P. P., Martins, C., Vaz, A. R., Conceição, E., Bastos, A. P., & Gonçalves, S. (2014). Eating disorder examination questionnaire: Psychometric properties and norms for the Portuguese population. European Eating Disorders Review, 22(6), 448-453.
Milano, W., De Rosa, M., Milano, L., Riccio, A., Sanseverino, B., & Capasso, A. (2013). The pharmacological options in the treatment of eating disorders. ISRN Pharmacology, 2013, n.p.
Stice, E., Rohde, P., Durant, S., Shaw, H., & Wade, E. (2013). Effectiveness of peer-led dissonance-based eating disorder prevention groups: Results from two randomized pilot trials. Behavior Research and Therapy, 51(4-5), 197-206.
What is a complete blood count? (n.d.). Web.
What is a TSH test? (n.d.). Web.