way beyond PICA!

  1. I have been researching the Net looking for info on PICA. We have a 23 year old woman, who this weekend swallowed a pen while in the ER.
    She has a history of this behavior since age 15, having ingested nails, razor blades, paper clips, etc. She has had 54 scopes, and 2 major abdominal surgeries. They got the pen out with a scope.
    This is way beyond Pica. She is not psychotic, has been diagnosed schizoaffective.
    I've been in psych a long time and this is one of the sickest young women I've ever met.
    Does anyone have a good site for information on this kind of behavior?
    I honestly don't see much hope for this poor woman, she has been in the mental health system for years. Any input? thanks, PGH70(Barb)
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  2. 10 Comments

  3. by   the new girl
    does she self abuse also?? Is she gamey? If so, I think she needs borderline personality disorder added to her AXIS. Otherwise, we had an adult male who ingested things, and almost died after swallowing batteries. Constant supervision???
  4. by   PhePhe
    I have a form of pica. My vice is ice. I eat it all the time and even buy slurpees in the winter. I just love half melted ice cubes and icy beverages--favorite part is the ice at the end.
  5. by   Shamrock
    WAY beyond pica is right. Sounds like she is swallowing things with the intent to inflict great harm to herself. My experience with pica is that they will eat anything, but it's usually dirt, soap, cig. butts.
    Can't help with any web sites but do know the schizoaffective are TOUGH to deal with. Surely she is on an antidepressent?
  6. by   PGH70
    Dear Shamrock, PhePhe and the new girl,
    thanks for your quick responses. She certainly should have borderline diagnosis also. I'll check when I go back to work tomorrow.
    She does not self abuse, other than the ingestions, as far as I know.
    She is on one to one constant supervision, and probably will be for a long time. This is hard on staffing, but necessary is some cases.
    new girl, I'm not quite sure what gamey means, if it means is she manipulative--YES!
    she is on antidepressants, and PRN klonopin. she doesn't sleep too much, so she may have some bipolar in there too.
    and dear PhePhe, I had that form of pica too, so much that my teeth wore down. At different times of my life, and it always went along with anemia. Last summer my hemoglobin was 7--I was an ice eating machine!
    This is great to have other pycho nurses to compare notes with, thanks,
    Barb
  7. by   sanakruz
    I've seen plenty of schizoaffective individuals that were QUITE psychotic.

    Does she have a low IQ? Many borderline MR (as opposed to borderline PD) swallow things as an negative way to seek attention.
    In 1983 I watched a man in a camisole (straitjacket) take a parakeet from a cage and swallow it whole. It was like something out of the X-Files!!! The unit was fully staffed too . No body was fast enough for this guy! I suspect that there is a name for this disorder. Yes it's beyond pica, but I dont know what on earth it is!!!!
  8. by   night owl
    We had an aquarium in the alcove of our unit, but the goldfish were disappearing. One day I caught one of our schizophrenic fellas sitting in his w/c by the tank...and BINGO! He won the jackpot!!! Stuck his hand right in, pulled out a fish and swallowed it whole...made me gag. Went over and wheeled him away from the tank and said, "Would you like fries with that?" as he cussed me out. Needless to say we got rid of the tank...
    Another "gentleman" we had needed constant and I mean constant supervision. Put anything and everything in his mouth. light bulbs off the Christmas tree, those little round things that hang from the shades so you can pull them down in the window, latex gloves, bars of soap, shoelaces...unbelievable! He saw it, he ate it.
  9. by   Shamrock
    Originally posted by night owl
    We had an aquarium in the alcove of our unit, but the goldfish were disappearing. One day I caught one of our schizophrenic fellas sitting in his w/c by the tank...and BINGO! He won the jackpot!!! Stuck his hand right in, pulled out a fish and swallowed it whole...made me gag. Went over and wheeled him away from the tank and said, "Would you like fries with that?" as he cussed me out. Needless to say we got rid of the tank...
    Another "gentleman" we had needed constant and I mean constant supervision. Put anything and everything in his mouth. light bulbs off the Christmas tree, those little round things that hang from the shades so you can pull them down in the window, latex gloves, bars of soap, shoelaces...unbelievable! He saw it, he ate it.
    hahaha, one of the best I tried to figure out was man with
    RED lips/mouth eating the christmas decorations... candles/bulbs]ect..........
  10. by   Nurse Izzy
    Blech...wandered in on the wrong thread....

    <wandering away to go eat some dirt>
  11. by   Charis
    hey everyone.............

    I'm very new to the world of MR ----just a year old now and happen to be a director of care. My background is ICU nursing
    so this is a real challenge.

    Is MR considered Psych nursing?
    I can find care plan on Bipolar disorders, or PICA, or OCD can you guys point me in the directions of some resources that my be online?

    Thanks Charis

    PS ck out my thead on the nursing management section of this site. Your ideas would be very helpful.
  12. by   Charis
    sorry... I cannot find careplans........can you help me?

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