EATING DISORDERS

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EATING DISORDERS

• Mercedes A. Perez-Millan MSN ARNP

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FACTS ABOUT EATING DISORDERS

• 2000 Statistics
• 9 out of 10 are female
• 5 million American women affected
• Key health issue for young women
• Mortality rate is 10 to 15 and the risk of
  suicide is increased

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COMORBIDITY

• Major depressive disorder- 50-70
• Bi-polar disorder- 4 13
• Obsessive-Compulsive disorder 25
• Substance abuse (bulimia)- 30-37
• Substance abuse (anorexia)- 12-18
• Personality disorders 42 75

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ANOREXIA NERVOSASPECIFIC FEATURES

• Individual weight is less than 85 of normal
• Intense fear of becoming fat
• Body image disturbance
• Strenuous exercising and particular food handling
  patterns
• Lack of sense of control in any area of life
  besides weight control
• Isolates self and denies that there is a problem

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ANOREXIA NERVOSAASSESSMENT

• PHYSICAL SYMPTOMS
• Less than 85 of normal weight
• Bradycardia, hypotension
• Arrythmias
• Hypokalemia
• Hypocalcemia
• Dehydration
• Amenorrhea

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ANOREXIA NERVOSAASSESSMENT

• PHYSICAL SYMPTOMS- Continuation
• Hypoglacemia
• hypothermia
• Lanugo, dry skin, hair loss
• Osteoporosis
• Constipation

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TYPES OF ANOREXIA

• Restricting
• Binge-eating/Purging

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Nursing DiagnosisAnorexia

• Altered nutrition less than body requirements
• Decreased cardiac output
• Risk for injury- electrolyte imbalance
• Risk for imbalanced fluid volume
• Disturbed body image
• Chronic low self steam

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NURSING CARE FOR ANOREXIA

• Monitor daily caloric intake
• Observe for signs of purging
• Monitor activity level
• Weigh daily
• Plan for dietician to meet with patient
• Monitor electrolytes

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BULIMIA NERVOSA

• Recurrent episodes of uncontrolled binge eating
• Purging a variety of compensatory behaviors to
  rid self of food
• Anxiety escalates before binging
• Binges leads to feelings of loss of control,
  guilt, depression, humiliation and self loathing
• Over-concern with body shape and weight

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BULIMIA NERVOSA ASSESSMENT

• SYMPTOMS
• Secretive eating
• Frequency of binge varies
• Abuse of laxative and diuretics
• Close to normal weight maintained

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BULIMIA NERVOSA ASSESSMENT

• PHYSICAL SYMPTOMS
• Bradycardia, hypotension, arrythmias
• Hypokalemia, hyponatremia, dehydration
• Irregular menses, hypogkacemia
• Hoarseness,dental caries, enlarged parotid
  glands, esophagitis
• Constipation

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NURSING DIAGNOSISBULIMIA NERVOSA

• Decreased cardiac output
• Risk for injury- electrolyte imbalance
• Disturbed body image
• Powerlessness
• Chronic low self-esteem
• Ineffective coping (substance abuse)

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NURSING CAREBULIMIA

• Motivated for treatment
• Set limits - very manipulative
• Create trust non-judgmental
• Help to identify feelings before binge-eating
• Help to increase self-esteem
• Teach patients about bulimia