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Adime Note Allison 2
Adime Note Allison 2
ASSESSMENT
The patient stated when she eats meals she will eat a lot and then purge
(4-7X/day). Her safe foods are smoothies, fruits and drinks in general. The patient
only drinks Deer Park water and Vitamin Water brands. The patient stated that she
feels a total loss of control when eating, purchases her own food and stores it in her
room. The patient has a history of restricting and counting calories.
Medications:
Rx birth control, ethinyl estradiol-norgestimate and medroxyprogesterone.
Hx amphetamines abuse for weight loss.
Physical activity:
Low intensity cheerleading 2 hr. 2x/week.
Client Hx The patient is a sophomore in college studying biochemistry. She lives with her
maternal grandparents, mother and brother. The patient has a family history of
bipolar, anxiety, and maternal grandparents with suspected eating disorders. The
patient has a past medical history of GERD and depression. She has a history of
cutting and some obsessive tendencies. The patient has a history of physical abuse
in elementary school by her stepfather. She reported a suicide attempt in 2013, and
has no suicidal ideation currently. The patient stated that she struggles with body
image and does body checking, body comparisons, and weighs self frequently.
DIAGNOSIS
Disordered eating pattern related to harmful beliefs about food and/or body image as evidenced by weight fluctuations (105 – 130lb), fatigue,
dizziness, cold intolerance, hair thinning, easy bruising and a stated feeling of loss of control when eating.
INTERVENTION
1. Nutrition Education
● Review the effect of purging on general health and related health risks (dehydration, and electrolyte imbalance).
● Meal plan: educate on what and “item” is and what are the main food groups.
2. Collaboration of Care
● Collaborate with other providers (eating disorder therapists) to encourage behavior change.
● Encourage the patient to review a list of therapists that specialize in eating disorders.
3. Skill Development
● Recommend distraction techniques to develop skills to eliminate purging.
4. Nutrition Counseling
● Use motivational interviewing to determine patient-centered strategies to eliminate eating disorder behaviors.
● Encourage self-monitoring by recommending journaling most days of the week for accountability for purging episodes.
● Patient Goals
1. Stop binge/purging behaviors.
2. Keep a food journal.