This  final project should be considered a culmination of the work throughout  the course. In week 2, you selected a case option to review and analyze  (they are lis

Case Summary and Analysis

Anna Spence

APUS

Case Study Summary

In this case, there is a significant presentation on a patient with Avoidant Restrictive Food Intake Disorder (AFRID), accommodating specific ailment identification, management, hospitalization, and medication for comprehensive case management. Particularly, the case involves a 12-year-old Irish girl with an AFRID diagnosis who has been on three hospital admissions between March 2018 and May 2019. Alayah is a 12-year-old female living with both active parents in school with many friends and a notable struggle of wanting to be “the best” on the ground. Noteworthy, the patient has no psychiatric or medical history with their parents, brother, and sister close to her and is worried about the fact that Alayah is not eating and is losing weight. According to the case, Alayah has been in three hospital admissions depending on the severity of the AFRID condition and overall clinical and psychiatric examination and outcomes. Two weeks earlier, Alayah was referred to the Emergency Department (ED) in Wexford General Hospital (WGH) Ireland for severe constipation and Movicol. At the time of first admission, Alayah had lost 2kg with a weight: of 41.2kg, height: of 161.7 cm, and BMI of 15.8 which is at the 15th percentile. The Patient presented notable symptoms and manifestations including vomiting after solids and having no appetite, to drink water but complaining of nausea and cramps in the abdomen while having no energy and severe constipation, dizziness, crushing fatigue, and body with no history of binge eating. Two weeks later, Alayah was re-admitted to the hospital upon the OPD review due to a notable weight drop to 39.4 kg and her BMI is now 15 which is in the 6th percentile Sexual development was classified as Tanner stage 2. During the second admission, there was a decision to include a multi-disciplinary approach in the pediatric team, creating an undeniable platform for effective case management. Alayah gradually improved (weight =45kg, BMI = 17.2: 33rd centile) and was discharged from the hospital after 2 months of treatment. Five months later, Alayah’s weight dropped to 39.2kg, and BMI of 14 in the 3rd centile, hence a decision to be referred to Liaison Psychiatry. At the time, there was a significant diagnosis of indulging a multidisciplinary care plan for effective case management. Therefore, the case accommodates a patient with Avoidant Restrictive Food Intake Disorder (AFRID), accommodating specific ailment identification, management, hospitalization, and medication for comprehensive case management. Particularly, the case involves a 12-year-old Irish girl with an AFRID diagnosis who has had three hospital admissions between March 2018 and May 2019, adopting a multidisciplinary care plan for effective case management.

Development Stage

Alayah is at a critical stage of development which is an adolescence development stage, accommodating notable measures of development and outcomes. Accordingly, the adolescence stage is marked by puberty changes occurring two years earlier in females than in male counterparts. Significantly, puberty changes are assessable using Tanner staging. Changes such as accepting a new body, separating from home, and establishing as an adult and individual in society dominate puberty changes among adolescents. In this case, Alayah is at Tanner stage II of sexual devolvement including changes such as breast budding, long downy pubic hair, peak growth velocity, and overall body changes and growth that are critical toward normal and positive growth and devolvement. Similarly, Alayah’s case resonates with the fifth psychosocial development stage (identity vs. role confusion) occurring during the teenage years. Noteworthy, the stage plays a critical role in personal identity, influencing behavior and future life. Effective growth at this stage is critical for self-identity and subsequent personal identity, however, failure in the normal devolvement stage may cause role confusion and weak self-perception and identity. Noteworthy, during the adolescence stage, individuals with proper encouragement and reinforcement via personal exploration merge as strong self-identified individuals with independent feelings and control. Alayah’s case accommodates the fifth stage of psychosocial devolvement and adolescence biological human growth and development. According to the authors, there are notable factors including genetic, fetal health, after-birth concerns such as socioeconomic, family characteristics, nutrition issues such as malnutrition, deficiencies, growth, environmental factors, and the role of childhood experience impacts human growth and devolvement (Balasundaram & Avulakunta, 2023). Therefore, the case provides notable impacts on nutrition and malnutrition occurrence due to Avoidant Restrictive Food Intake Disorder (AFRID) which interferences with normal growth and devolvement.

Influence on Growth

In this case, Alayah is in the Sexual development of Tanner stage 2 accommodates a new body, separating from home, and oneself establishment as an adult and individual in the society dominates the puberty changes among adolescents. Notably, The Patient presented notable symptoms and manifestations including vomiting after solids and having no appetite, drinking water but complaining of nausea and cramps in the abdomen while having no energy and severe constipation, dizziness, crushing fatigue, and a body with no history of binge eating. Malnutrition, deficiencies, and a lack of weight management would hinder Alayah’s natural challenges, creating significant impacts on normal development. Similarly, as an adolescent, the patient needs effective consideration in nursing for effective and vital growth and development. Therefore, the case accommodates a multidisciplinary care plan for effective case management.

References

Balasundaram, P., & Avulakunta, I. (2023). Human Growth and Development. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK567767/

Naviaux, A. F. (2019). Management of ARFID (avoidant restrictive food intake disorder) in a 12-year-old on a pediatric ward in a general hospital: Use of mirtazapine, partial hospitalization model and family-based therapy. Psychiatria Danubina, 31(3), 421-426.

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