NU 665 WEEK 8 DISCUSSION POST
NU 665 WEEK 8 DISCUSSION POST
Initial Post
For this discussion, you will complete the Eating/Feeding Disorders Case Study. You will need a minimum of two scholarly references to support your work, one of which should be from a nursing journal.
Create a video up to five minutes long addressing the following prompts:
- Create a case formulation/biopsychosocial assessment for this patient.
- Create a list of differential diagnoses.
- What is your primary diagnosis?
- What are the pharmacologic, non-pharmacologic, and lifestyle modifications that can be addressed with Alice and her mother on this visit?
- Describe any plans you would have for interprofessional collaboration on this case.
To create your video, follow the instructions for Zoom Tutorial and create an unlisted YouTube video. The following tools can be used to create your video: Zoom or your personal preference.
You will need to submit the YouTube video URL for this discussion. The best way to do this is to copy and paste the hyperlink URL for the YouTube video into a Word document. Your faculty will access your video via the link. Do not upload a video file (mp4).
Primary Care of the Psychiatric Mental Health Client II
Eating Feeding Disorders Case Study
Alice is a 10-year-old girl in a gifted and talented school who you, the PMHNP, assume care for following a referral from her PCP for suspected anxiety symptoms. The PCP was concerned that anxiety symptoms may be interfering with her appetite, as it was also reported that Alice had drifted below the
10th percentile for weight. During the initial interview, Alice’s mother states that Alice’s eating difficulties started at age 9, when she began refusing to eat and reporting a fear that she would vomit. At that time, her parents sought treatment from her pediatrician, who continued to evaluate her yearly, explaining that it was normal for children to go through phases. At age 9, Alice was above the 25th percentile for both height and weight (52 inches, 58 pounds), but by age 10, she had essentially stopped growing and had dropped to the 5th percentile on her growth curves (52.5 inches, 55 pounds). The only child of two professional parents who had divorced 5 years earlier, Alice lived with her mother on weekdays and with her nearby father on weekends. Her medical history was significant for her premature birth at 34 weeks’ gestation. She was slow to achieve her initial milestones but by age 2 was developmentally normal. Yearly physical examinations had been unremarkable except for the recent decline of her growth trajectory. Alice had always been petite, but her height and weight had never fallen below the 25th percentile for stature and weight for age on the growth chart. Alice was a talented student who was well liked by her teachers. She had never had more than a few friends, but recently she had stopped socializing entirely and had been coming directly home after school, reporting that her stomach felt calmer when she was in her own home. For the prior year, Alice had eaten only very small amounts of food over very long durations of time. Her parents had tried to pique her interest by experimenting with foods from different cultures and of different colors and textures. None of this seemed effective in improving her appetite. They also tried to let her pick restaurants to try, but Alice had gradually refused to eat outside of either parent’s home. Both parents reported a similar mealtime pattern: Alice would agree to sit at the table but then spent her time rearranging food on her plate, cutting food items into small pieces, and crying if urged to eat another bite. When asked more about her fear of vomiting, Alice remembered one incident, at age 4, when she ate soup, and her stomach became upset and then she subsequently vomited. More recently, Alice had developed fear of eating in public and ate no food during the school day. She denied any concerns about her appearance and said that she had first become aware of her low weight at her most recent visit to the pediatrician. When educated about the dangers of low body weight, Alice became tearful and expressed a clear desire to gain weight.
Introduction
For this discussion, you will review the Eating/Feeding Disorders Case Study, focusing on Alice, a 10-year-old girl presenting with significant changes in eating behavior, weight loss, and social withdrawal. Eating and feeding disorders in children are complex and multifactorial, often influenced by biological, psychological, and social factors that interact over time. Early recognition and intervention are essential to prevent long-term nutritional deficits, emotional distress, and developmental complications.
Alice’s case highlights how anxiety-related behaviors and conditioned fears can significantly disrupt a child’s normal eating patterns. Despite having no concerns about body image, she demonstrates intense fear of vomiting, avoidance of eating outside her home, and consistent food restriction resulting in slowed growth and weight loss. These symptoms suggest the possibility of Avoidant/Restrictive Food Intake Disorder (ARFID), a diagnosis distinct from anorexia nervosa or bulimia nervosa, where food avoidance stems from fear or sensory sensitivities rather than a drive for thinness.
In this discussion, a biopsychosocial assessment will be used to explore how Alice’s medical history, developmental background, family dynamics, and emotional state contribute to her current symptoms. A list of differential diagnoses will be developed to guide diagnostic clarity, followed by identification of the primary diagnosis. The presentation will also outline appropriate non-pharmacologic, and lifestyle interventions aimpharmacologic, ed at restoring healthy eating behaviors and addressing underlying anxiety. Finally, the discussion will emphasize the importance of interprofessional collaboration, involving pediatricians, nutritionists, therapists, and family members to ensure comprehensive care and long-term recovery.
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