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, Sexual abuse: want to keep childlike body, afraid of sexual maturity
Neglect
Social anxiety
A tendency toward perfectionism
Inflexible thinking – all or nothing thinking
Fear of losing control
o Understanding Eating Disorders:
Do not concentrate on food – Eating disorders are EMOTIONAL PROBLEMS
Attempt to control, hide, avoid & forget pain, stress & self-hate
Most prevalent in industrialized societies where thinness is considered the attractive ideal
Anorexia Nervosa: begins around puberty and involves extreme weight loss
o Diagnosis is made from:
A refusal to maintain a normal body weight - Dropping below 15% ideal body weight
Absence of menstruation for at least 3 months
Distorted view of body size, shape and weight
Intense fear of gaining weight
Disturbed body image (believing one is fat despite emancipation)
o Anorexic Thinking:
Need for control
Food rituals
Preoccupied with weight& shape
Restrict eating
See themselves as fat
Withdrawn socially
o Signs & Symptoms: Anorexia Nervosa
, Cachectic: muscle wasting
Lanugo: soft hair growth over body (r/t inadequate protein in diet)
Mottled cool skin
Dehydration
Thin, brittle hair
Dry broken out skin that is gray or yellowed
Dental problems and gum disease
Feeling cold much of the time
Depression, isolation, loneliness
Insomnia
o Physical Complications: Anorexia Nervosa
Vital sign abnormalities ( BP)
Electrolyte imbalances
Osteoporosis
Abnormal thyroid function
Cardiac abnormalities (irregular HR)
Fatty degeneration of liver, elevated cholesterol
Kidney infection & failure (Hematuria&Proteinuria)
o Nursing Process: Anorexia Assessment Guidelines
Determine if medial/psychiatric condition warrants hospitalization (appropriate testing important)
Severe hypothermia, bradycardia, hypotension, hypokalemia, cardiac abnormalities
Weight loss more than 30% over 6 months
Suicidal of self-mutilating behaviors
Severe depression or psychosis
Emotional problems
Chaotic family relationships
o Treatment: Anorexia Nervosa
, RefeedingSyndrome: emergency status causing cardiac collapse and possible death
Generally treat on an outpatient basis unless a medical emergency occurs
Patient will usually fight the tx because they fear gaining weight and losing control
Can be manipulative and will lie to avoid exposure that they are not eating
Family MUST be a part of the recovery process for support
CBT, group therapy, family therapy and medication for depression
Bulimia Nervosa
o Diagnosis is made from:
Assessment and the history of behaviors
Recurrent episodes of binge eating followed by self-induced vomiting, misuse of laxatives or
diuretics
Behaviors are designed to prevent weight gain – not necessarily to lose weight
Patient will often be at normal or near normal weight so diagnosis is usually made off of patient
history and behaviors
o Characteristics: Bulimia Nervosa
Being a “people pleaser”
Low self-esteem
Depression, isolation and loneliness
Preoccupation with food; hoarding, hiding or stealing food
o Physical Complications:
Upset stomach
Burning throat (acid reflux)
, Sexual abuse: want to keep childlike body, afraid of sexual maturity
Neglect
Social anxiety
A tendency toward perfectionism
Inflexible thinking – all or nothing thinking
Fear of losing control
o Understanding Eating Disorders:
Do not concentrate on food – Eating disorders are EMOTIONAL PROBLEMS
Attempt to control, hide, avoid & forget pain, stress & self-hate
Most prevalent in industrialized societies where thinness is considered the attractive ideal
Anorexia Nervosa: begins around puberty and involves extreme weight loss
o Diagnosis is made from:
A refusal to maintain a normal body weight - Dropping below 15% ideal body weight
Absence of menstruation for at least 3 months
Distorted view of body size, shape and weight
Intense fear of gaining weight
Disturbed body image (believing one is fat despite emancipation)
o Anorexic Thinking:
Need for control
Food rituals
Preoccupied with weight& shape
Restrict eating
See themselves as fat
Withdrawn socially
o Signs & Symptoms: Anorexia Nervosa
, Cachectic: muscle wasting
Lanugo: soft hair growth over body (r/t inadequate protein in diet)
Mottled cool skin
Dehydration
Thin, brittle hair
Dry broken out skin that is gray or yellowed
Dental problems and gum disease
Feeling cold much of the time
Depression, isolation, loneliness
Insomnia
o Physical Complications: Anorexia Nervosa
Vital sign abnormalities ( BP)
Electrolyte imbalances
Osteoporosis
Abnormal thyroid function
Cardiac abnormalities (irregular HR)
Fatty degeneration of liver, elevated cholesterol
Kidney infection & failure (Hematuria&Proteinuria)
o Nursing Process: Anorexia Assessment Guidelines
Determine if medial/psychiatric condition warrants hospitalization (appropriate testing important)
Severe hypothermia, bradycardia, hypotension, hypokalemia, cardiac abnormalities
Weight loss more than 30% over 6 months
Suicidal of self-mutilating behaviors
Severe depression or psychosis
Emotional problems
Chaotic family relationships
o Treatment: Anorexia Nervosa
, RefeedingSyndrome: emergency status causing cardiac collapse and possible death
Generally treat on an outpatient basis unless a medical emergency occurs
Patient will usually fight the tx because they fear gaining weight and losing control
Can be manipulative and will lie to avoid exposure that they are not eating
Family MUST be a part of the recovery process for support
CBT, group therapy, family therapy and medication for depression
Bulimia Nervosa
o Diagnosis is made from:
Assessment and the history of behaviors
Recurrent episodes of binge eating followed by self-induced vomiting, misuse of laxatives or
diuretics
Behaviors are designed to prevent weight gain – not necessarily to lose weight
Patient will often be at normal or near normal weight so diagnosis is usually made off of patient
history and behaviors
o Characteristics: Bulimia Nervosa
Being a “people pleaser”
Low self-esteem
Depression, isolation and loneliness
Preoccupation with food; hoarding, hiding or stealing food
o Physical Complications:
Upset stomach
Burning throat (acid reflux)
