Case Study 1

Jamie is a student nurse and a single mother, and is working part time to help defray the expenses of her college education. At the beginning of the fall semester, Jamie had a physical examination. She is 4 feet 10 inches tall and weighs 150 pounds. She loves to cook culturally different foods and spends her weekends cooking for her family. Jamie’s mother visits for the Christmas holidays. Jamie has been wearing several layers of clothes that appear too large. So Jamie’s mother took her on a shopping trip to the mall to buy Jamie a new wardrobe. Jamie’s mother notices that her daughter has lost several pounds during the fall semester. Jamie has a medium frame and very little fat without much muscle. Her mother is worried and asks her daughter about the apparent weight loss. Jamie denies that she appears thinner than usual. Jamie’s husband tells her mother that Jamie has been eating small portions of food for the last 4 months. Jamie says that she eats while she is preparing meals and that she is not hungry by the time she sits down at the table. Jamie is seen by her primary care physician at the insistence of her mother. The nurse weighs Jamie and notes that she has gone from 140 pounds to 95 pounds since her physical in the fall. Her blood pressure is 95/70 mm Hg. She complains of dizziness and chronic constipation. Her last menstrual period was 3 months ago and only lasted 1 day.

What medical diagnosis is most consistent with the above medical history and symptoms?
What would be the contrasting presenting history and symptoms of bulimia nervosa? (Hint: refer to Chapter 18)

Case Study 2

Judy is the charge nurse in the ICU on the day shift. In the morning she receives report from the night charge nurse. Judy has noticed lately that her coworker has a slightly slurred speech in the morning and can hardly stay awake long enough to give report. Some of the night nurses have seen the charge nurse wasting patient’s unused narcotics without a witness on several occasions. The nurses on the night shift have recently started to complain about the night charge nurse’s short absences from the unit during the night shift.

What legal and ethical responsibilities do the nurses have to the professional individual abusing substances?
Why is reporting the substance abuse important in this situation? (Hint: refer to Chapter 17)
Text Book: Psychiatric-Mental Health Nursing

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