1. In order to appropriately care for this patient, a psychiatric evaluation will be needed. It will be necessary to know the family history, and the personal history to determine how long the eating disorder has been present, and what may have caused it, e.g. traumatic event in her life. Initially, she needs rehydrating to lower her BUN, creatinine, Hgb and Hct to within normal limits. An EEG should be performed to see if there is any brain damage from starvation (Eating, 2005). Liver function tests should be performed, along with thyroid function tests, and serum estrogen levels should be determined.
2. Tammy is most likely suffering from anorexia nervosa. Her clinical picture is consistent with this diagnosis (Eating, 2005).
3. Anticipated interventions for anorexia nervosa include restoring normal body weight and eating habits, and attempting to resolve the psychological issues which led to the disorder through psychotherapy (Anorexia, 2005). This may require intravenous feeding initially. It will require supportive care by health care providers which may include structured behavioral therapy, and antidepressant drug therapy. Joining a support group for people with eating disorders may also be advised.
4. During the clinical day it will be necessary to measure food and liquid intake to make sure the patient is consuming sufficient calories to help restore her normal body weight. She will need to be observed for purging to make sure she does not regurgitate the food she eats. Her urine output should be monitored to monitor her kidney function make sure it is returned to normal. Blood samples will need to be taken daily to check electrolytes, creatinine, Hgb and Hct to monitor kidney function and make sure the patient does not develop anemia. Electrocardiograms should be performed to check that cardiac abnormalities do not occur.
5. The patient is suffering from insufficient dietary intak
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