Medical Assessment

A medical evaluation is necessary to examine the physical effects of the patient's food restriction and to rule out alternative or contributory causes of vomiting or weight loss (Rome et al. 2003). In the hospital, the patient should be weighed after voiding and while wearing a hospital gown. In addition to routine vital signs, orthostatic blood pressure and pulse should be obtained. The assessment should include baseline electrocardiogram and laboratory studies (see Table 10-4). Bone densitometry should be obtained in patients at high risk for bone loss (i.e., those with 6 months or more of amenorrhea or significant eating disorder symptoms) (American Psychiatric Association 2006; Rome and Ammer-man 2003). Evaluation by a dietician is important in determining the patient's caloric and nutritional needs while identifying specific nutritional deficiencies and developing an individualized nutritional rehabilitation plan.

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