Johanna is a 15-year-old who was sent to North York General Hospital from Southlake Hospital with eating disorder – anorexia nervosa.
HISTORY OF PRESENTING ILLNESS:
Johanna has been restricting her food intake since November 2013. She states that for the month of November to December, she would chew her food and then spit it out. She said during this time she was also calorie counting and using excessive amounts of water intake and gum to curb her appetite. Over the month of December, she furthered her weight loss attempts by fasting. Johanna states she would go days on end without consuming any food and would only consume Diet Pepsi. During this time, she did state that she would have occasional binges where she would consume between 2000-6000 calories. She did not partake in any purging activity but did use an herbal cleansing pill which she says was a laxative after these binges. She did not use any diuretics. She states that she would try and exercise to maintain her weight loss but would only be able to do it in 5-10 minute increments because of her fatigue.
Johanna saw her family doctor in November and again in December when it was noted that she had a weight loss from 159 pounds to 157 pounds. At this time, Johanna’s doctor put in a requisition to the eating disorder program in New Market, however Johanna’s family has not heard back from the clinic yet and in fact stated that it sounds like they are full until April.
Johanna has complained of presyncope when moving from a sitting to standing position. She has also had 2 syncopal episodes when standing up from sitting down. She complains of cold intolerance, thinning hair and fatigue. She was encouraged by her parents to eat more over the last month, but had abdominal p...
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...the exam that this was actually the dye that had rubbed off from her clothing. Bowel sounds were normal and there were no masses palpated. The rest of her dermatologic exam revealed some areas of redness and dry skin to her lower extremities and upper arms. There was no lanugo detected.
IMPRESSION AND PLAN:
Johanna is a 15-year-old previously healthy girl who has been suffering from an eating disorder, anorexia nervosa, for the past few months. When she was seen before coming to North York General Hospital, she expressed that if she did go home she would refuse to eat, which prompted the admission here. Over the next few days, the day team will create a plan along with the dietitian with regards to the nutrition that Johanna requires. We will be monitoring her electrolytes, weight and urine output as well.
Thank you for including us in the care of this patient.
by fossilized rocks and the skulls of apelike men. The poet laureate of the age, Alfred, Lord Tennyson, the voice of the Victorian people, expresses his horror and bewilderment at the implications of these scientific discoveries in "In Memoriam A. H. H." In sections 54, 55, and 56 of this lengthy poem, Tennyson finds his belief in God weakened and his faith foundering in the face of scientific fact. In the face of evolution, geology, and natural selection, ... ... middle of paper ... ...eration
As if molded directly from the depths of nightmares, both fascinating and terrifying. Serial killers hide behind bland and normal existences. They are often able to escape being caught for years, decades and sometimes an eternity. These are America’s Serial Killers (America’s Serial Killers). “Even when some of them do get caught, we may not recognize what they are because they don’t [sic] match the distorted image we have of serial killers” (Brown). What is that distorted image? That killers live
Murder Castle “I was born with the devil in me. I could not help the fact that I was a murderer, no more than the poet can help the inspiration to sing. I was born with the evil one standing as my sponsor beside the bed where I was ushered into the world, and he has been with me since.” (qdt. in Roland 12) Mudgett, better known as H.H. Holmes, said this during a confession in 1896. Holmes is diligently studied and sometimes admired because, not only was he America’s first major serial killer, the
Holmes was first charged with insurance fraud, and then the murder of Benjamin Pitezel (H.H. Holmes Biography, 2015). He was never charged with the deaths of any of his victims in Chicago due to the inability to positively identify any victims (H.H. Holmes, 2004). Holmes gave numerous stories to police about what happened in “The Murder Castle”, and admitted to at least 27 murders, but again, the exact number is not known. Holmes acted as his own lawyer in the case of murder and insurance fraud against
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One of the first men to single handedly terrorize the nation was Herman Webster Mudgett, more commonly known as H.H. Holmes. As a rather successful businessman with a degree in medicine, few would suspect the horrible secrets he kept locked away in the hotel he had built as his own personal torture chamber. By the time he was arrested, Mudgett had already taken an upwards of one hundred lives in a way that would shock the world. Born on May 16, 1861 in Gilmanton, New Hampshire to devout Methodist
The Hotel of Horrors There was a man with a name of Herman Webster Mudgett, but most people know him by the name of H.H. Holmes(“H.H. Holmes”, 2017:Grey, 2016: Upton, 2014). I had first heard about this weird part of America’s history through one of my favorite television shows, Supernatural. He is known to be one of the most cruel serial killers in the United States, and no one really know the exact amount of people he has killed. But how did he kill so many people without getting caught sooner
It is a divided issue whether D. H. Lawrence is to be considered a friend or a foe to the feminist movement. On one hand, he advocates an egalitarian man-woman relationship, on the other, his notion of equality seems rather subject to qualification. His reference to the ideal monogamous partnership as "phallic marriage" (Spilka 7) is certainly a cue that must be taken up. Why is marriage "phallic" unless the phallus is privileged in the expression of sexuality? (de Beauvoir 205) The idealisation
activity I have ever been involved in is 4-H. I have been a member of the Cheerful Champs 4-H club for almost ten years. When you join a 4-H club the members and leaders become your friends and family. 4-H’s mission is to provide a positive environment for kids to grow and succeed through. With such an environment 4-H hopes to give kids confidence and empower them to do whatever they hope to achieve. Empowerment turns kids into leaders and teachers. After being in 4-H so long you learn how to lead and teach
According to the USCIS the H-1B visa was created to employ ‘foreign workers in specialty occupations that require theoretical or technical expertise in specialized fields’. The visa is valid for three years from the date issued and may be renewed for another three years. Visas may be applied for during a short period of time at the beginning of each fiscal year in October. The H-1B is considered a ‘non-immigrant’ visa but it does have dual intent. This means a holder of the H-1B can have current legal
(Rollyson 1). Within one year of ... ... middle of paper ... ...ed "H. G. Wells." Enotes.com. Ed. Joseph Palmisano. Enotes.com, 2004. Web. 27 Feb. 2012. . Hartesveldt, Fred R. van. "H. G. Wells." Dictionary Of World Biography: The 20Th Century (2000): 1-3. Literary Reference Center. Web. 27 Feb. 2012. Loveday, Veronica. “H. G. Wells.” H.G. Wells (2005): 1-2. Literary Reference Center. Web. 9 Feb. 2012 Rollyson, Carl. “H. G. Wells.” Magill’s Survey Of World Literature, Revised Edition (2009):
John H. Johnson was born January 19, 1918 in rural Arkansas City, Arkansas. His parents were Leroy Johnson and Gertrude Jenkins Johnson. His father was killed in a sawmill accident when little John was eight years old. He attended the community's overcrowded, segregated elementary school. In the early 1930s, there was no public high school for African-Americans in Arkansas. His mother heard of better opportunities for African-Americans in Chicago and saved her meager earnings as a washerwoman and
“Piano” by D. H. Lawrence The poem Piano, by D. H. Lawrence describes his memories of childhood. Hearing a woman singing takes him to the time when his mother played piano on Sunday evenings. In the present, this woman is singing and playing the piano with great passion. However, the passionate music is not affecting him, because he can only think about his childhood rather than the beauty of the music that exists in his actual space. “A woman is singing” softly to the speaker “in the dusk
Question: i. To explore 4-H marketing strategies in involving the Hispanic population in Clark County to decrease high school drop out in the Hispanic community. b. Background of 4-H i. The 4-H pledge provides a foundational understanding of the goals of this more than 100 year-old youth development program. This comprehensive approach to youth development offers young people important developmental opportunities to foster a successful transition to young adulthood. The 4-H Program was created in
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