Full Answer Section

• Muscle Wasting: Starvation leads to muscle breakdown, impacting metabolism, strength, and organ function.
• Bone Density Loss: Reduced calorie intake and hormonal changes lead to osteoporosis, increasing fracture risk.

2. Contributing Factors

• Cultural: Cultures with a strong emphasis on thinness as a beauty ideal can increase the risk of AN. (Source: Journal of Eating Disorders, Thompson & Nazar, 2018)
• Financial: Financial stress and food insecurity can contribute to disordered eating patterns. (Source: International Journal of Eating Disorders, Becker et al., 2018)
• Environmental: Exposure to bullying or teasing about weight, or a history of physical or sexual abuse, can increase the risk of AN. (Source: International Journal of Eating Disorders, Hudson et al., 2008)

3. Priority Nursing Interventions in the Emergency Department

• Stabilization: Immediate assessment of vital signs, hydration status, and electrolytes to address any life-threatening conditions.
• Psychological Assessment: Evaluate the patient’s mental state, suicidal ideation, and understanding of the severity of their condition.
• Nutritional Counseling: Educate the patient about the importance of refeeding and the development of a healthy relationship with food.
• Safety Planning: Collaborate with the patient and family to develop a plan to prevent further self-harm behaviors.
• Family Support: Provide support and education to family members on how to best care for the patient at home. (Source: Journal of Emergency Nursing, Mehler et al., 2019)

4. Labs and Diagnostic Testing

• Electrolytes: Measure electrolytes (potassium, sodium, calcium, etc.) to identify imbalances that may require immediate correction.
• Complete Blood Count (CBC): Assess for anemia or infection, common complications of malnutrition.
• Metabolic Panel: Evaluate electrolytes, kidney function, and liver function, which can be affected by starvation.
• Thyroid Function Tests (TFTs): Rule out thyroid disorders that can mimic symptoms of AN.
• ECG (Electrocardiogram): Detect potential cardiac arrhythmias caused by electrolyte disturbances. (Source: International Journal of Eating Disorders, American Psychiatric Association, 2022)

Critical Indicators:

• Low potassium levels: Can cause cardiac arrhythmias, potentially fatal.
• Anemia: Indicates malnutrition and decreased oxygen-carrying capacity of blood.
• Electrolyte imbalances: Can lead to various complications including muscle weakness, fatigue, and cardiac issues.
• Abnormal heart rhythm on ECG: Requires immediate intervention to prevent serious complications.

5. Interdisciplinary Team

• Psychiatrist: Leads the treatment plan, including medication management and psychotherapy.
• Registered Dietitian (RD): Develops a personalized refeeding plan and educates the patient on healthy eating.
• Social Worker: Provides support and resources for the patient and family, addressing social and environmental factors.
• Primary Care Physician: Provides ongoing medical care and monitors for complications of AN.
• Physical Therapist: Helps restore muscle strength and function. (Source: Academy of Eating Disorders [AED], 2023)

Rationale: A holistic approach is crucial for successful treatment. Each team member plays a specific role in addressing the biological, psychological, and social aspects of AN.

Sources:

• Academy of Eating Disorders (AED). (2023). Retrieved from https://www.nationaleatingdisorders.org/
• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed.). doi: 10.1176/appi.books.978.0.30019891