Eating disorders order 10

Eating disorders order 10

• 1.
  Eating Disorders
• 2.
  Eating Disorders  Anorexia Nervosa  Bulimia Nervosa  Eating disorder not otherwise specified (NOS)  Binge eating
• 3.
  Theories  Neurobiological: altered neurotransmitters  Neuroendocrine: abnormalities, hypothalmic dysfunction  Genetic: there is a heriditary predisposition to developing disorders  Psychodynamic Influences/ Family Relationships
• 4.
  More theories  Psychological: feelings of low self- esteem/ harsh self judgement due to feelings of doubt  Sociocultural: Increases in societies where women have a choice in role models  Genetic: strong link for eating disorders
• 5.
  Clinical Presentation  Anorexia:  Terror of gaining weight  Preoccupied with thoughts of food  View self as fat  Peculiar handling of food  Exercise obsessed  May use vomiting/ diuretics  Determines self worth through weight
• 6.
   Bulimia:  Binge eating  Self-induced vomiting  May have a hx of anorexia  Depressive signs  Problems with interpersonal relationships. Self concept, and impulsive behaviors
• 7.
   Anorexia  Bulimia  Low weight  Usually normal weight  Amenorrhea  Tooth erosion  peripheral edema  Calluses on hands  Constipation  Electrolyte imbalance  Cardiac px  failure  BP  failure
• 8.
   Client with Anorexia  Perfectionisn  Obsessive thoughts and actions relating to food  Need to control  Therefore, MUST build a trusting empathetic relationship
• 9.
   Assessment: malnourished, underweight, lanugo on face, mottled skin, dehydration ô Nursing Diagnosis: Imbalanced Nutrition : less than body requirements… Decreased cardiac output… Disturbed body image…
• 10.
   Outcome criteria: short term vs long  Planning:  Inpatient vs Outpatient  Refeeding Syndrome  Stabilize first if pt is under 75% idea weight or with extreme electrolyte imbalance  Outpatient therapy then begins
• 11.
   Acute phase/ basic level  Milieu therapy (precise meal times, observation, weigh ins)  Counseling (to deal with cognitive distortions)  Health Teaching (self care)  Coping skills  Learning to shop and choose food  Eating forbidden foods
• 12.
   Psychotherapy  For not only pt but family as well  Psychopharmology  Prozac ( increases mood which may directly affect disorder)  Zyprexa (decreases agitation and obsessive behaviors)  EVALUATION : If weight fails below goal.. Methods are revised.
• 13.
   Bulimia  These clients are sensitive to the perceptions of others  May feel: shame, low self-esteem, unworthiness  Must build an empathetic and trusting relationship to be successful in helping these clients
• 14.
   Assessment:  May not appear ill, normal weight  Dental erosion  Family relationships may lack nurturing  May have hx of impulsive behaviors (stealing etc)  Electrolyte imbalance Diagnosis: Risk for injury due to ineffective coping…. Others???
• 15.
   Outcome Criteria  Short vs long term: electrolyte / acid base balance  Planning: tx life threatening complications  May be at risk for suicidal tendencies  Begin treatment to deal with issues leading to bulimia and prepare for discharge therapies
• 16.
   Acute phase:  Milieu therapy: interrupt binge/purge cycle  Counseling  Health teaching  Long term treatment:  Psychotherapy  Psychopharmacolgy (Prozac)
• 17.
   Normalize eating habits  Maintain regular exercise plan  Weight in normal range for height
• 18.
   A different type of compulsive overeating  Reported in 20-30% obese clients  Major depression  Most effective treatment is cognitive- behavioral therapy  SSRI’s (Zoloft) used to reduce binging
• 19.
   Do you know anyone with an eating disorder?  Anything you feel comfortable sharing? Examples? Anyone? Only if you are comfortable?