During a well-child physical, a 16-year-old girl has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand

Question

Her body mass index is in the 25th to 50th percentile for her age. Based on these findings, which disorder would the nurse suspect? 1. Anorexia nervosa
2. Bulimia nervosa
3. Marasmus
4. Kwashiorkor

Answer 1

2
Rationale 1: Anorexia nervosa is an eating disorder where individuals literally starve themselves to prevent weight gain and also exercise excessively and use laxatives and diuretics to lose weight. Anorexia usually manifests as extreme weight loss and an obsession with food.
Rationale 2: The erosion of the tooth enamel and the presence of dental caries and calluses on the back of her hand all most likely are due to frequent vomiting of gastric acids, which is common with this disorder as part of a "binge-purge" cycle.
Rationale 3: Marasmus is a lack of energy-producing calories that can be seen in anorexia; it causes emaciation, decreased energy levels, and retarded development.
Rationale 4: Kwashiorkor is a protein deficiency, usually from malnutrition, that manifests as generalized edema.
Global Rationale: