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FAQs During Admissions for Medical Stabilization of an Eating Disorder: Information for Clinicians

FAQs During Admissions for Medical Stabilization of an Eating Disorder: Information for Clinicians - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Nutrition, Related


For revisions, contact CCKM. | Last revised/reviewed: 11/2015
Reference: Assessment and Management of Eating Disorders – Pediatric/Adult – Inpatient Guideline
FAQ’s During Admissions for Medical Stabilization
of an Eating Disorder: Information for Clinicians
This document provides answers to frequently asked questions regarding hospital admissions of pediatric,
adolescent, and adult patients with an eating disorder. It is a component of the Assessment and Management of
Eating Disorders – Pediatric/Adult – Inpatient Clinical Practice Guideline.
Why am I here?
You were admitted to the hospital because of medical problems that come from poor nutrition.
This hospital stay will work on improving your nutrition. As your nutrition improves, your heart
rate, blood pressure and body chemistry will return to normal levels. It is our goal to help you
restore your nutrition in a place that will be supportive, and as rapidly as is safe. While you are
with us, there are several things we will be doing to ensure your safety, and return you to a
healthier state as quickly as possible.
These are the things we will focus on during your hospital stay:
ξ Correct your poor nutrition in a slow and steady way, and monitor the health of organs like
your heart. It is very dangerous if your nutrition is not managed in a proper way.
ξ Correct any problems with the salts in your blood (sodium, magnesium, phosphorous,
potassium). These chemicals in the blood need to be at certain levels for your body to be
able to function in a healthy way.
ξ Develop a post-hospitalization plan for you to continue to progress in your recovery once
discharged from the hospital.
ξ Ensure that you have resources to help you and your family understand your nutritional
needs after discharge.
What exactly will happen while I am here?
You will receive medicine in the form of energy to keep your body safe. We need to provide
your heart and vital organs with this medicine so that they can perform basic
functions. Sometimes this medicine will be delivered via a nasogastric, or NG tube, which
will be placed on the floor. We will also need to help you conserve energy in order to
protect your vital organs and restore your energy balance. All of this is part of restoring
your energy balance in order to make your body safe.
Can my parents or support person stay with me?
Your parents are welcome, and encouraged, to stay with you throughout your stay, however
they may not bring any food in from home for you. They also may not dispose of any food or
other items in your room.
Why is there someone watching me in my room all the time? Don’t you trust me?
You may have more than one nurse and care partner during your stay. A care partner (also
called patient safety attendant) will be with you in the room or watching you on a video monitor.
A lot of the things we ask you to do here at the beginning of the hospitalization are difficult, and
the PSA will help you keep up with them all. The goal is to ensure your safety and most rapid
recovery.
Copyright © 2015 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2015CCKM@uwhealth.org

For revisions, contact CCKM. | Last revised/reviewed: 11/2015
Reference: Assessment and Management of Eating Disorders – Pediatric/Adult – Inpatient Guideline
Why do I need to be hooked up to a heart monitor and have my vital signs checked?
Because your blood pressure may drop when you stand up, we will be checking your blood
pressure while you are lying in bed and upon standing each morning. Due to low heart rates and
the possibility of heart rhythm problems, you will be placed on a heart monitor. This monitor will
alert the nurse if there is a concern. We will also be checking your blood pressure, temperature,
and oxygen saturation periodically throughout the day.
Why do you need to check my blood and do all of these tests?
As your body moves from its state of malnutrition to health we will monitor blood tests to make
sure that change does not happen too fast. If that change happens suddenly there can be
dangerous effects on your heart and brain. To look for and prevent that danger, we need to
check some blood tests on admission and frequently (every 12 hours, or possibly more often)
after that. We also need to do an EKG (electrocardiogram) to check your heart. We will try to
draw blood from an IV. If you do not have an IV or we are unable to, we have a numbing cream
that we can put on your skin so that the blood tests are less uncomfortable.
Who are all these people coming into my room?
Because poor nutrition has compromised your health, we have a large medical team to help you
get healthy again. This includes pediatric hospitalist physicians, resident physicians, nurse
practitioners or physician’s assistants, psychiatrists, adolescent medicine specialists, nurses,
and patient safety attendants. You will also have a team of clinical nutritionists and dieticians to
help plan and monitor your nutritional treatment, since food is the medicine that you need to get
healthy. You may see other health care team members such as physical or occupational
therapists, social workers, case managers, or health psychologists. We work together to help
you become healthy again soon.
I don’t like hospital food, can I choose my own?
During your stay, we will provide a nutritious diet. This will include providing the vitamins and
minerals your body needs to be healthy. All of your food must come from the hospital kitchen.
No outside food is allowed. Your meals will be planned by your dietician. Your dietitian will go
over your food preferences on admission. We will do our best to incorporate the foods you like
and avoid the foods you prefer not to eat. Once your Food Preference worksheet is turned in,
you cannot make any changes. These rules are in place to make sure you have adequate
nutrition in proper amounts and makeup, and that the pace of your recovery is safe and steady.
I am a slow eater; can I have more time for my meals and snacks? When do meals
and snacks arrive?
Your meals and snacks will be delivered to your room within specific time frames. Your nurse
can tell you these times so that you feel prepared. You will be required to eat the number of
meals and snacks on your meal plan. You will always have 3 meals. Snacks will be incorporated
slowly. You will have 30 minutes to eat meals, and 20 minutes to eat snacks. If you are not able
to finish a meal or snack, you will be given a liquid supplement to make up for it. No one will be
angry with you if you take the supplement instead of finishing the meal. If you are not able
to drink the supplement, the nurse will give the supplement through a nasogastric tube.
I don’t understand why I may need a nasogastric tube. Why might it be necessary?
The medicine that your body needs in order to treat this condition and help your heart regain
strength is nutritional energy. Sometimes it is very challenging to take that energy orally. The
nasogastric tube is a simple way of making the process of taking the energy easier so that your
Copyright © 2015 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2015CCKM@uwhealth.org

For revisions, contact CCKM. | Last revised/reviewed: 11/2015
Reference: Assessment and Management of Eating Disorders – Pediatric/Adult – Inpatient Guideline
heart and body reach a safer state. The nurses will place the tube for you. After that you will be
able to relax and receive the energy safely and without worry or pressure.
I don’t like to be in bed all the time, I don’t feel well when I do, so can I get up?
You will need to rest a lot and you may not exercise. We will place you on bed rest and fall
precautions when you arrive. Resting in bed is necessary to help your heart regain strength as
soon as possible. Therefore, you may sit up in bed, but may not walk around the room. The
team may allow you to participate in hospital activities and spend some time out of bed or out of
room in a wheelchair when your vital signs and heart rhythm are stable.
A note about bathroom privileges:
If you are stable, you can shower and use the bathroom however you may only be up 5 minutes
at a time. You can shower only once per day. Please do not flush the toilet as nursing will be
recording all output. You may not use the bathroom for 1 hour after meals or snacks unless
directly supervised. For bathroom and shower breaks, you will need to be supervised by your
nurser or care partner in case you feel faint.
A note about weight measurements:
Staff will obtain your weight every morning. You should not eat or drink anything before the
weight. Please empty your bladder before weighing. You will wear your underwear and a patient
gown for the weight (no bra). Your hair must be dry (we will weigh you before your shower). We
will have you face away from the scale. We will not discuss the weight with you.
I don’t like all these rules!?
These rules are not made to punish you. These rules have been shown to help keep this
hospitalization safe and as short as possible. While the rules are strict, they are necessary while
we are helping to improve your nutrition and help your body work normally again. We want you
to become healthy again in a safe way.
Copyright © 2015 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2015CCKM@uwhealth.org