Coordination of CareNutrition Interventions


205


tient hospitalization even if they are not medically unstable.)


• Malnourished and/or refusing oral intake, possibly requiring nutrition support, and weight less than 75% of expected body weight (adults)


• Malnourished and/or refusing food or acute weight loss, even if weight is within normal limits (children)


• Purging and/or self-harming unless constantly su- pervised; may be actively suicidal; may secretly exercise if left unsupervised; requires supervision using the bathroom


• Resistant and/or uncooperative in recovery, requir- ing constant structure and external motivation to remain safe; actively attempting to sabotage medical/ nutrition care


Box 11.3 Signs of Medical Instability


• Heart rate less than 40 beats per minute (adult) or 50 beats per minute (child or adolescent)


• Blood pressure less than 90/60mmHg (adult) or 80/50mmHg (child or adolescent)


• A drop in blood pressure greater than 10 to 20mmHg when rising from sitting to standing position


• Plasma glucose level less than 60mg/dL • Serum potassium less than 3mEq/L • Body temperature less than 97°F • Dehydrated, hypokalemic, or hypophosphatemic, and/or experiencing hepatic, renal, or cardiovascular complications requiring acute treatment


Source: Data are from reference 2.


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