Chapter 22: Eating Disorders (Children) Flashcards
4 Categories of Eating Disorders
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder
- eating disorder not otherwise specified
Who does eating Disorders affect?
- most affect females
- adolescent males are also known to suffer from these illnesses
Anorexia Nervosa
purging or withholding
-can become life-threatening problem or cause death because of severe weight loss that can result in electrolyte imbalance and hemodynamic instability
Bulimia Nervosa
binging and purging
Binge eating Disorder
binging without purging
Risk Factors for Development of an Eating Disorder
- family genetics
- rigidity, ritualism in home
- stressful life event
- hormonal and physiological changes associated with puberty
- “picky” eater in childhood
- participation in sports that focus on the pursuit of thinness
Signs and Symptoms
- inordinate concern and gross distortion of body image and body weight
- preoccupation with food
- hide behaviors related to food and caloric intake from others
- depression
- anxiety
- family discord; conflict avoidance
- weight loss up to 85% of ideal body weight
- consuming caloric intake but then purging by vomiting
- vigorous physical activity
- amenorrhea
- weakness
- fatigue
Diagnostic Criteria for Anorexia Nervosa
- weight less than 85% of expected weight
- distorted body image
- absence of three consecutive menstrual cycles
Diagnostic Criteria for Bulimia Nervosa
- lack of control over eating
- recurrent inappropriate compensatory behavior to prevent weight gain, such as vomiting
- cycle of binge eating and inappropriate compensatory behaviors occurring at least twice a week for 3 months
Assessment for Eating Disorders
- perception of issue, shape, and weight
- eating habits
- mental status: cognitive distortions: “my life is over if I gain 5 pounds”
- participation in rigorous physical regimen
- vitals: blood pressure, pulse, and temperature will be low
- lanugo
- jaundice
- cool extremities with poor skin turgor
- dental erosion, if purging
- peripheral edema
Laboratory Tests for Eating Disorders
> abnormal lab results associated with eating disorders
- hypokalemia (low potassium)
- hyponatremia (low sodium)
- anemia (lack healthy RBCs)
- leukopenia (low WBC)
- increased liver enzyme levels
- elevated bilirubin level
- decreased levels of follicle-stimulating hormone
Diagnostic tools
-electrocardiogram changes such as prolongation of the QT interval, bradycardia, and ventricular tachycardia with a risk of sudden death also needs to be evaluated
Prevention
- nurse is best position to identify early cases of eating disorders and refer for preventative individual and family treatment
- keep in mind assessment needs to be conducted within a growth and developmental perspective and that intervention is considered within a family-based approach
Nursing Care
-provide a highly structured environment
-involve patient in decision making and participation in the plan of care
-assist patient in setting realistic weight goals
-promote cognitive reframing: assist patient in changing the negative perception to a positive one
-monitor patients weight, vitals, intake and output, caloric intake, and exercise
>no drugs that are specific for eating disorders; medications that treat the core symptoms such as selective serotonin reuptake inhibitors (SSRIs) in reducing obsessive compulsive behaviors and craving for carbohydrates
Education/Discharge
- when making referrals for treatment, important to consider the skill level of the treatment clinician, and often a team approach with expertise in this area of health and mental health works best
- instruct families that treatment for eating disorders can take a long time and that family members will be involved in the recovery
