EATING DISORDERS Flashcards
excessive concern about food and weigh control
EATING DISORDERS
simply loss of appetite. It is a symptom. It is not a disorder, but a symptom of an abnormal condition.
ANOREXIA
- mental illness, a disorder.
- Self-starvation syndrome
- Relentless pursuance of thinness
- Weight: < 85% of their Ideal Body Weight (IBW)
ANOREXIA NERVOSA
What is the normal BMI?
Give the BMI for Anorexia Nervosa Patients
Normal: 18-24.9
BMI: <17.5
TYPES OF ANOREXIA NERVOSA
- Not eating
- Excessive excercising
RESTRICTIVE TYPE
TYPES OF ANOREXIA NERVOSA
- Extreme weight losing diet and excessive excerise
- They sometimes binge/purge
VOMITER/PURGER TYPE
What is the difference between vomiter type and bulimia?
Frequency; If less than the requirement for bulimia nervosa then it is anorexia; BN has specific frequency per week
COMMON MANIFESTATIONS OF ANOREXIA
- Because they are severely malnourished, their body is unable to produce a certain hormones needed
AMENORRHEA
COMMON MANIFESTATIONS OF ANOREXIA
- When you are not eating, you can have ulcer or
hyperacidity - Even if you don’t eat, your stomach is still producing
hydrochloric acid
EPIGASTRIC PAIN
COMMON MANIFESTATIONS OF ANOREXIA
They will have fluid and electrolyte imbalance that may cause hypokalemia and hyponatremia
EXCESSIVE EXCERICES
COMMON MANIFESTATIONS OF ANOREXIA
NO ORGANIC CAUSE FOR WEIGHT LOSS
Does not have any other disorder that causes severe malnutrition
What is the main problem of Anorexia Nervosa Patients
INTENSE FEAR OF WEIGHT GAIN
- They are obsessed about food but they don’t want to eat
- Patients have a high knowledge about nutrients, caloric diet because they are obsessed, they research about it.
Nursing diagnosis for Anorexia Nervosa Patients
Disturbed/Altered Body Image
- THEY ARE OBVIOUSLY THIN BUT FEELS FAT
They don’t eat because of loss of appetite, in fact they don’t lose their appetite, it’s their choice not to eat at all.
REFUSAL TO MAINTAIN NORMAL WEIGHT/ REFUSAL TO EAT
What are the defense mechanism used by anorexic patients?
suppression and denial
- They also refuse to acknowledge the seriousness of
their problem
PERSONAL PROFILE OF PATIENTS WITH ANOREXIA NERVOSA
- mnemonics: PAYAT
Perfectionists
Achievers in School - Disciplined
Yearns thinness
A good daughter/Son - Submissive to their parents
Teens
PERSONAL PROFILE OF PATIENTS WITH ANOREXIA NERVOSA
Perfectionist
- What is the type of parents/type of toilet training
- What dominates their personality?
- Rigid type
- superego
PERSONAL PROFILE OF PATIENTS WITH ANOREXIA NERVOSA
Common age group where they are diagnosed with anorexia nervosa
Teens
- According to Mary Townsend, girls are more
conscious with their body
PERSONAL PROFILE OF PATIENTS WITH ANOREXIA NERVOSA
In what developmental stage is crucial in root cause of anorexia nervosa
Toddlers
- Because of the type of toilet training
-Not eating or losing weight is their way of
achieving self-control.
WHAT ARE THE FAMILY SYSTEMS THEORY IN ANOREXIA NERVOSA
- Overprotective family
- Chaotic Family
- Achieving oriented family
What kind of overprotective family does anorexia nervosa patient have and what does it mean?
- Family enmeshment
- Family that has no clear boundaries.
- In attempt to be autonomous and
independent, they will not eat or control their eating habits thus, weight loss can be observed.
What causes anorexia nervosa among patients with chaotic family?
- Emotional problems
- No emotional support given who is susceptible in
anorexia nervosa - They have a lot of unexpressed emotions, and In
attempt to forget unexpressed emotions they will not eat.
They Consciously forget they want to eat
Anorexia Nervosa
Unconsciously forget their problems while losing weight
Anorexia Nervosa
NEUROLOGICAL THEORY for Anorexia Nervosa patients?
High Serotonin Levels - the reason why their appetite immediately satisfied (madaling mabusog)
Insatiable appetite ( walang kabusugan )
BULIMIA
COMMON MANIFESTATIONS: BULIMIA
Bingeing then Purging
Consume a large amount of something in a very short (discrete) period
BINGEING
induced vomiting, excessive use of laxative or
diuretics
PURGING
What are the defense mechanism used by bulimic patients?
Undoing
Nursing Diagnosis for bulimia nervosa?
Powerlessness
INDUCED VOMITING
- the knuckles get intouch with their teeth
while trying to induce vomiting hence it will have
lesions.
Russel’s sign
INDUCED VOMITING
- damaged esophagus because of
frequent vomiting
Mallory weiss sign
MINIMUM OF _______________ BIENGING AND PURGING
ATLEAST ONCE PER WEEK
What is firstly observed on bulimic patients?
dental caries - due to stomach acid from vomit
In which aspect of the teeth has most of the dental caries ?
Posterior aspect - of the teeth has the most contact with the vomit.
Who usually discovers Bulimia Nervosa?
Dentists - because of dental caries
ETIOLOGY PSYCHOANALITIC THEORY of BN
- When did bulimia nervosa start?
infancy because of their unmet oral
needs.
- They compensate during adult years by overeating to satisfy their oral needs
ETIOLOGY PSYCHOANALITIC THEORY of BN
having two opposite thoughts or feelings
* They will feel WORTHY or UNWORTHY
AMBIVALENT FEELINGS
NEUROCHEMICAL THEORY for Bulimia Nervosa?
Low serotonin levels - Appetite is slow to satisfy
NURSING DIAGNOSIS for BN
- Altered Nutrition (Less than body requirements
- Fluid Volume Deficit
- Not eating and drinking as well
- Self-Esteem Disturbance
- Disturbed Body Image
- Ineffective individual Coping
They are aware of their problems that’s why they hide
Bulimia Nervosa
NURSING INTERVENTION for both disorders
EDUCATE CLIENT ABOUT THE DISORDER AND ALTERNATE COPING MECHANISM: art, pets,
poetry, and any leisure activities that do include sleeping and eating.
ENCOURAGE THE CLIENT TO EXPRESS THEIR FEELINGS. HOWEVER, BOTH PATIENTS HAVE Alexithymia, what does this mean?
difficulty in expressing feelings and concerns.
MONITOR PATIENT’S WEIGHT
- Same time, Same type of clothes and Same weighing scale.
- Monitor after defecating and voiding, but usually only after voiding because it is difficult to defecate in the morning.
To make sure that the patient eat all the required food she needed.
SUPERVISE THE CLIENT DURING MEAL TIME
- Where the patient can be seen by nurses
- To avoid tendency of bingeing and purging
ENCOURAGE PATIENT TO REMAIN IN PUBLIC PLACES
TREATMENT OF CHOICE
-What is the main treatment?
Behavioral modification therapy
- Giving rewards for desired behaviors so that it will
be repeated
- Don’t use food as reward
Psychopharmacology: SSRI ( low serotonin level )
- Prozac
- PRaxil
- Zoloft
what is the priority among all the nursing diagnosis?
FLUID VOLUME DEFICIT
