NCM 116 – Care of Clients with Maladaptive SEM 02
Patterns of Behavior, Acute and Chronic FINALS
Lecturer: Dr. Cefer S. Sales, RN, MD, MHM, CHA
UNIT 4 – CHAPTER 20: EATING DISORDERS
TOPIC OUTLINE weights and longest durations of illness tended to
I. Anorexia Nervosa relapse most often and have the poorest outcomes.
II. Bulimia Nervosa Clients who abuse laxatives are at a higher risk for
III. Related Disorders medical complications.
IV. Application of the Nursing Process
ANOREXIA NERVOSA
• Anorexia Nervosa is a life-threatening eating disorder
characterized by body weight less than below
minimum expectations, an intense fear of being fat, a
severely distorted body image, and refusal to eat or
binge eating and purging.
• Clients with anorexia become totally absorbed in their
quest for weight loss and thinness. The term
“anorexia” is actually a misnomer; these clients do not
lose their appetites. They still experience hunger but
ignore it and also ignore the signs of physical
weakness and fatigue; they often believe that if they
eat anything, they will not be able to stop eating and
will become fat.
PHYSICAL PROBLEMS OF
ANOREXIA NERVOSA
TREATMENT AND PROGNOSIS
• Clients with anorexia nervosa pose challenges in
treatment due to their resistance, lack of interest, and
denial of their condition. The appropriate treatment
setting depends on various factors such as the
severity of the illness, including weight loss, physical
symptoms, duration of disordered eating behaviors,
drive for thinness, body dissatisfaction, and presence
of other psychiatric conditions.
Clients with Anorexia Nervosa can be classified into • The effectiveness of short hospital stays is observed
two subgroups depending on how they control their in clients who are open to weight gain and experience
weight. Clients with the restricting subtype lose weight rapid weight gain while hospitalized. On the other
primarily though dieting, fasting, or excessive exercising. hand, individuals who resist weight gain and have
• Binge Eating - means consuming a large amount of slower progress may require longer inpatient stays.
food (far greater than most people eat at one time) in Outpatient therapy has higher success rates for
a discrete period of usually 2 hours of less. clients who have been ill for less than 6 months, do
not engage in binging and purging behaviors, and
• Purging - involves compensatory behaviors
have parents who are likely to actively participate in
designed to eliminate food by means of self-induced
family therapy. Cognitive-behavioral therapy (CBT) is
vomiting or misuse of laxatives, enemas, and
another effective approach for preventing relapse and
diuretics.
improving overall outcomes.
Some clients with anorexia do not binge but still
• In cases of major life-threatening complications like
engage in purging behaviors after ingesting small
severe fluid imbalances, electrolyte abnormalities,
amounts of food.
metabolic disturbances, cardiovascular issues,
extreme weight loss, and suicidal risk, hospital
ONSET AND CLINCAL COURSE
admission becomes necessary.
• Anorexia nervosa typically begins between the ages
of 14 and 18 years. In the early stages, clients often
MEDICAL MANAGEMENT
deny having a negative body image or anxiety
Medical management focuses on weight restoration,
regarding their appearance. As the illness
nutritional rehabilitation, rehydration, and correction of
progresses, depression and lability in mood become
electrolyte imbalances.
more apparent. As dieting and compulsive behaviors
→ Clients receive nutritionally balanced meals and
increase, clients isolate themselves.
snacks that gradually increase caloric intake to a
• For clients with anorexia, about 30% to 50% achieve
normal level for size, age, and activity.
full recovery, while 10% to 20% remain chronically ill.
Patterns of Behavior, Acute and Chronic FINALS
Lecturer: Dr. Cefer S. Sales, RN, MD, MHM, CHA
UNIT 4 – CHAPTER 20: EATING DISORDERS
TOPIC OUTLINE weights and longest durations of illness tended to
I. Anorexia Nervosa relapse most often and have the poorest outcomes.
II. Bulimia Nervosa Clients who abuse laxatives are at a higher risk for
III. Related Disorders medical complications.
IV. Application of the Nursing Process
ANOREXIA NERVOSA
• Anorexia Nervosa is a life-threatening eating disorder
characterized by body weight less than below
minimum expectations, an intense fear of being fat, a
severely distorted body image, and refusal to eat or
binge eating and purging.
• Clients with anorexia become totally absorbed in their
quest for weight loss and thinness. The term
“anorexia” is actually a misnomer; these clients do not
lose their appetites. They still experience hunger but
ignore it and also ignore the signs of physical
weakness and fatigue; they often believe that if they
eat anything, they will not be able to stop eating and
will become fat.
PHYSICAL PROBLEMS OF
ANOREXIA NERVOSA
TREATMENT AND PROGNOSIS
• Clients with anorexia nervosa pose challenges in
treatment due to their resistance, lack of interest, and
denial of their condition. The appropriate treatment
setting depends on various factors such as the
severity of the illness, including weight loss, physical
symptoms, duration of disordered eating behaviors,
drive for thinness, body dissatisfaction, and presence
of other psychiatric conditions.
Clients with Anorexia Nervosa can be classified into • The effectiveness of short hospital stays is observed
two subgroups depending on how they control their in clients who are open to weight gain and experience
weight. Clients with the restricting subtype lose weight rapid weight gain while hospitalized. On the other
primarily though dieting, fasting, or excessive exercising. hand, individuals who resist weight gain and have
• Binge Eating - means consuming a large amount of slower progress may require longer inpatient stays.
food (far greater than most people eat at one time) in Outpatient therapy has higher success rates for
a discrete period of usually 2 hours of less. clients who have been ill for less than 6 months, do
not engage in binging and purging behaviors, and
• Purging - involves compensatory behaviors
have parents who are likely to actively participate in
designed to eliminate food by means of self-induced
family therapy. Cognitive-behavioral therapy (CBT) is
vomiting or misuse of laxatives, enemas, and
another effective approach for preventing relapse and
diuretics.
improving overall outcomes.
Some clients with anorexia do not binge but still
• In cases of major life-threatening complications like
engage in purging behaviors after ingesting small
severe fluid imbalances, electrolyte abnormalities,
amounts of food.
metabolic disturbances, cardiovascular issues,
extreme weight loss, and suicidal risk, hospital
ONSET AND CLINCAL COURSE
admission becomes necessary.
• Anorexia nervosa typically begins between the ages
of 14 and 18 years. In the early stages, clients often
MEDICAL MANAGEMENT
deny having a negative body image or anxiety
Medical management focuses on weight restoration,
regarding their appearance. As the illness
nutritional rehabilitation, rehydration, and correction of
progresses, depression and lability in mood become
electrolyte imbalances.
more apparent. As dieting and compulsive behaviors
→ Clients receive nutritionally balanced meals and
increase, clients isolate themselves.
snacks that gradually increase caloric intake to a
• For clients with anorexia, about 30% to 50% achieve
normal level for size, age, and activity.
full recovery, while 10% to 20% remain chronically ill.
