Anorexia School Nurse Care Plan

[dietsprite]

Hello,

This is my first post, and I am in desperate need of your opinions as to what your priority in this case would be. I have a hypothetical case study of an adolescent who comes into a school nurses office (I am the nurse) referred to by another teacher who is worried about her recent weight loss.

She is in denial as to the fact that she has a problem which is clearly anorexia nervosa (BMI below 18, loss of menstrual cycle, has lost significant weight recently, self perception of being overweight, etc). However, the client claims she is eating well and does not have a problem.

I have to create a comprehensive careplan with sever diagnoses (actual and risk). The two primary actual diagnoses I have chosen are Ineffective Denial and Imbalanced Nutrition: Less than Body Requirements. I am not including the entire diagnosis (3 part) for purposes of academic integrity - should you need more information, you may message me privately.

My question is whether I should intervene first with the client's denial of the situation instead of her nutritional status since this is an outpatient setting and she is not in immediate risk of death or serious harm. I believe that any interventions related to nutrition will be ineffective until I at least tackle the fact that there is denial of an underlying problem. Then, I can slowly educate her on nutrition and show her how her own symptoms correspond to a poor nutritional intake.

In conclusion, I have two questions:

1. Is it always necessary to address the goal of establishing nutritional balance before a goal lower on the hierarchy, or only if the status is severe?

2. In this particular case, would you address the client's denial prior to to addressing their nutrition? Or do you believe that it will not make a difference in terms of success?

Thanks