Unit 31 Eating Disorders Flashcards
Who is mainly affected by eating disorders?
White females,
Middle/Upper socioeconomic class
What has the highest premature mortality rate of any psychiatric illness?
Anorexia Nervosa has the highest premature mortality rate of any psychiatric illness.
What are predisposing factors to anorexia and bulimia?
Biological influences
- gender
- family history
- serotonin
Psychological influences:
- Perfectionistic people pleaser
- Difficulty communicating negative emotions and resolving conflict
- Low Self-Esteem
- Stressful times of transition
- History of obesity/dieting/bullying
Sociologic influences
-Media
What is Anorexia?
- Self-Induced starvation developing from an intense fear of becoming obese
- Gross distortion of body image, perceiving self as “fat” even when emaciated
- Preoccupation with food and refusal to eat
What results from Anorexia?
- Extreme weight loss, more than 15% or original body weight
- Hypothermia, bradycardia, hypotension, edema, metabolic changes
- Amenorrhea (no menstruation) may precede significant weight loss
- Anxiety and Depression
- Osteoporosis
- Lanugo
What are symptoms of inadequate calorie intake?
Amenorrhea (no menstruation) Colds hands/feet Constipation Dry skin and hair Headaches Fainting/dizziness Lack of energy No apetite Difficulty concentrating Irritability Depression Social withdraw Food obsession Delayed cap refill
What is Bulimia and describe.
Episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food (binging) followed by one or more of the following behaviors (purging)
- Self induced vomiting
- Misuse of laxatives, diuretics, enemas
- Vigorous or excessive exercise
- Mean onset is 18 years old
- More prevalent than anorexia
- Binge foods: HI calorie, sweet, soft, smooth texture
- Binging usually in secret and terminated only if abdominal discomfort, sleep, or social activities interrupted
- Feelings of self degradation and depressed mood commonly follow an episode
What are Bulimia manifestations?
- Normal weight range but may fluctuate
- Possible electrolyte imbalance and dehydration
- Erosion of tooth enamel from gastric acid
- Possible tear in gastric or esophageal mucosa
- Depression, anxiety
- Cardiac dysrhythmias
- Possible substance abuse (alcohol or amphetamines)
What is the most important nursing Diagnosis related to Anorexia and Bulimia?
-Imbalanced Nutrition: Less than body requirements
What are nursing actions for Anorexia and Bulimia?
- Determine needed nutritional requirements
- Explain behavior modification plan
- Weights and I and O daily
- Assess skin turgor and mucous membranes
- Stay with client during meals and for 1 hr post meals to process anxiety
- Limit meals to 30 minutes
What are positive outcome of Anorexia and Bulimia intervention?
Client gains 2-3 lbs per week
No signs of malnutrition/dehydration
Consumes adequate calories
Does not stash food or self-induce vomiting
In regards to Ineffective Denial nursing dx, what nursing actions should be implemented?
Develop trusting relationship, give positive regard
Don’t bargain, explain how privileges and consequences are based on compliance with therapy and weight gain
Encourage client to verbalize feelings
If a patient has a nursing diagnosis of Disturbed Body Image Low Self-Esteem, what actions should be implemented?
Help client develop realistic perception of body
Allow client independent decision-making
Give positive feedback
Help client accept self
Convey that perfect is unrealistic
How would you engage patients in treatment?
Nurturing-Authoratative approach: Kind, but firm
- Focus on HEALTH, rather than weight
- Use motivational interviewing
- Emphasis on will power, self determination
- Avoid blame, fault, guilt
The therapist serves as their consultant, advisor, health expert
What are the nutritional treatment strategies?
- Exercise as a healthy, not dysfunctional habit
- Frequent small meals (5-6 per day)
- Limit diet foods
- Nutritional supplements as needed
- Gradually increase to 2500 to 3000 calories a day
