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Eating disorders order 10

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Mental Health Fall '12

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Eating disorders order 10

  1. 1. Eating DisordersRenee Franquiz MSN, RN
  2. 2. Eating Disorders Anorexia Nervosa Bulimia Nervosa Eating disorder not otherwise specified (NOS)  Binge eating
  3. 3. Theories Neurobiological: altered neurotransmitters Neuroendocrine: abnormalities, hypothalmic dysfunction Genetic: there is a heriditary predisposition to developing disorders Psychodynamic Influences/ Family Relationships
  4. 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. 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. 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. 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. 8.  Client with Anorexia  Perfectionisn  Obsessive thoughts and actions relating to food  Need to control  Therefore, MUST build a trusting empathetic relationship
  9. 9.  Assessment  malnourished, underweight,lanugo on face, mottled skin, dehydration Nursing Diagnosis  Imbalanced Nutrition : less than body requirements…  Decreased cardiac output  Disturbed body image Planning  Inpatient vs Outpatient  Refeeding Syndrome  Stabilize first if pt is under 75% idea weight or with extreme electrolyte imbalance  Outpatient therapy then begins
  10. 10.  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
  11. 11.  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.
  12. 12.  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
  13. 13.  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
  14. 14.  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
  15. 15.  Acute phase:  Milieu therapy: interrupt binge/purge cycle  Counseling  Health teaching Long term treatment:  Psychotherapy  Psychopharmacolgy (Prozac)
  16. 16.  Normalize eating habits Maintain regular exercise plan Weight in normal range for height
  17. 17.  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

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