Solution-West Coast University
Anorexia
o divided in
▪ restrictive
• restrict caloric intake
▪ binge-eating/purging
• over-eat then vomiting
o Physical assessment (FINDINGS)
▪ weight loss <20% from IDEAL weight
• ideal weight depends on height
▪ LANUGO
• fine downy hair on face and back
▪ yellow skin
▪ pale
▪ COOL EXTREMITIES
• molted
▪ ACROCYNOSIS
• blueish color in the extremities
▪ poor skin turgor
▪ BINGE-EATING/PURGE
• self-induce vomiting
o calluses in the hands
o Russell’s syndrome
▪ scars in the hands
▪ RESTRICTIVE
• low level of estrogen
o Amenorrhea
Bulimia
o normal or elevated body weight
o personality disorder
▪ cluster B
• borderline personality disorder due to splitting moods
o irritability
o impulsiveness
o self-mutilation scars
o elevated fat
o elevated weight
o elevated caloric intake
o elevated binging
o BINGE-EATING/PURGE
▪ FINDINGS
• dental erosion
• enlargement of parotid gland
, LAB VALUES
o Patient’s method of purging
▪ laxative
▪ diuretic
▪ vomiting
▪ WHEN USING ANY OF THESE METHODS OF PURGING THE FOLLOWING LABS
ARE SEEN IN PATIENTS WITH ANOREXIA
• LOW K+ (POTASSIUM)
• LOW ALBUMIN
• HIGH CHOLESTEROL
o K+ (POTASSIUM)
▪ 3.5-5
▪ levels are low for both anorexia and bulimia due to the purging
o ALBUMIN
▪ 3.5-5
o Platelet count
▪ 150,000-400,000
• < than 150,000 thrombocytopenia
• > than 400,000 thrombocytosis
o CBC
o ECG
▪ prolonged QT interval
o Cholesterol
▪ elevated levels due to purging
o Liver Function
▪ Elevated enzymes
VITAL SIGNS
o LOW B/P
▪ risk for orthostatic hypotension
o LOW pulse
o LOW body temperature
o BINGE-EATING DISORDER
▪ HYPERTENSION
INTERVENTION
o 1 to 1 observation (always PRIORITY)
▪ Bulimia
• self-mutilation
• risk for suicide
▪ Anorexia
• encourage pt. to eat
• keep the food out
• after patient eats, Nurse needs to stay with patient for a minimum of 1
to 2 hour.