CRITICAL PATHWAY | Eating Disorders Program, Estimated Length of Stay: 28 Days Behavioral Unit
| Nursing Diagnosis and Categories of Care | Time Dimension | Goals/Actions | Time Dimension | Goals/Actions | Time Dimension | Goals/Actions |
| Altered nutrition: less than body requirements R/T inadequate intake, self-induced vomiting, laxative use | Ongoing | Gain 3 lb/wk as indicated (or 0.5 lb/day) | Day 2-28 | Consume at least 75% of food provided at each meal | Day 15-28 | Demonstrate ability to select foods to meet at least 80% of nutritional needs |
| Risk for fluid volume deficit | Ongoing |
Be free of signs/symptoms of dehydration |
Day 2-28 |
Ingest at least 1000 mL fluid/day |
Day 22-28 | Refrain from self-induced vomiting |
| Display balanced l&O | Day 3 | Vital signs WNL | Day 28 | Be free of signs/ symptoms of malnutrition with all laboratory results WNL | ||
| Referral | Day 1 and prn | Dietitian | ||||
| Diagnostic studies | Day 1 |
Electrolytes, CBC,
BUN/creatinine Thyroid function UA ECG as indicated |
Day 14 | Repeat selected studies | ||
| Additional assessments | Day 1-2 | Vital signs/I&O every shift | Day 3-7 qAM | Day 8-28 | As indicated | |
| Day 1 Day 1-28 |
Weight Types and amount of food/fluid intake Behavior/purging following meals Level of activity |
Day 7, 14 | 7:30 a.m., same clothes | |||
| Medications Allergies: | Day 1-28 |
Periactin Tricyclic antidepressant Vitamin supplement |
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| Patient education | Day 1 and prn |
Orient to unit and schedule Behavior modification program Minimum weight goal and initial nutritional needs |
Day 7-14 | Principles of nutrition; foods for maintenance of wellness | Day 21-28 | Incorporate nutritional plan into lifestyle and home setting |
| Additional nursing actions | Day 1-3 | Assist patient with formulation of behavioral contract and monitoring of cooperation | Day 7-28 | Involve mother/ significant other as appropriate in nutritional counseling and planning for future | ||
| Day 1-7 | Administer tube feeding/blenderized food as indicated |