Complex Case

[nurseT]

Does Anyone Have Experience With Anorexia?. I Have A 22 Yo Female, 5'9, 110 #, Hx Of Attempted Overdose With Her Psych Meds. She Takes 40mg Straight Paxil, 25mg Seroquel, I Think It Was 50mg Geodon And 10mg Of Ambien, All At Bedtime. She Swears She's Too Nauseated To Eat. She Sits On The Floor Next To The Toilet And Gags And Trembles. I Pulled Her To The Exam Room Today And Had Her Hold Hot Water Under Her Tongue For A Few Minutes And Spit It Out, I Had Crushed A Tablet Of Dramamine (antivert) Our Doctor Prefers This Med For Nausea, And Sprinkled The Powder Under Her Tongue And Made Her Allow It To Absorb. She Hated It But She Did Not Throw Up For 3 Hours And Rested A Little. She's In Jail For Nonsupport, She Used To Have Disability But Lost It When She Married A Guy Who Actually Works. She Has Major Depressive Disorder, Ptsd And Anorexia Nervosa. I Really Don't Quite Know What To Do With Her. She Does Need Behavior Management, But It's Like Beating A Dead Horse. Any Takers ?

[Nurse Ratched, RN]

Eating disorders are SO hard to deal with in patients, let alone in the corrections population. Maybe a search in the psych nursing forum would help?

FWIW, I believe she probably *is* nauseated, altho likely she won't eat even if she isn't. Can her meds be split up even a little?

[nurseT]

I wrote a letter to the judge about her condition. I was afraid she would have an MI. She lost 2 # in the first day of incarceration, She really needed a tube feed. He didn't know, and her attourney had made an offer to the prosecutor anyway, but the secretary did not notify him of the offer. They had court for her real quick and she was released. Very seldom do I write a letter to the judge. Our judges like it though. They get the real poop on whats going on and feel like they can make a more informed decision. I never tell the judge what to do, it's not like that. The jail is not a health care facility, and she really had the officers going. I was just getting the officers educated on the disease and how to cope with her puke games, when she got released. She was a mess. I'm still curious if anyone out there has experience with this disorder. My Commander had never seen a case in all the time he's been at the jail.