psychiatry useful

1. Good Morning…

2. Bulimia Nervosa
Presented by ,
Ms. Ankita R. Hiwarale,
M.Sc nursing 1st year,
Dr .P.D.N.I.Amravati.

3. INTRODUCTION
 Eating disorders refer to a group of conditions defined by abnormal
eating habits that may involve either insufficient or excessive food intake
to the detriment of an individual's physical and mental health. Bulimia
nervosa, anorexia nervosa, and binge eating disorder are the most common
specific forms in the United States.
 Bulimia Nervosa is characterized by episodes of binge eating
followed by feelings of guilt, humiliation, depression and self-
condemnation.

4. DEFNITION
 “It is an eating disorder marked by binge eating i.e.
out of control eating, followed by purging, such as
vomiting, taking laxative, and/or excessive activity to
prevent the individual from gaining weight
- (Stanley, 1999).”

5. ETIOLOGY

6. CLINICAL FEATURES

7. COMPLICATIONS
 Gastric rupture during period of binge eating.
 Dental caries , erosion , of tooth enamel , parotitis and gum
infection.
 Dehydration or electrolyte imbalance.
 Chronic irregular bowel movements and constipation from
laxative use
 Increased risk of suicide and psychoactive substance abuse.

8. DIAGNOSIS
 The diagnosis of bulimia nervosa cannot be made if the
binge-eating and purging behaviors occur exclusively
during episodes of anorexia nervosa. In such cases, the
diagnosis is anorexia nervosa, binge eating-purging type.
 Medical evaluation to rule out upper gastro intestinal
disorder.
 Psychological evaluation and Beck Deprssion Inventory.

9. Cont…
 History
 Laboratory test ( serum electrolytes , blood glucose ,
baseline ECG )
 Confirmed if ICD 10 criteria met.

10. TREATMENT
Pay attention on chart

11. NURSING INTERVENTIONS
 Engage patient in therapeutic alliance to obtain commitment to
obtain commitment to treatment.
 Establish contract with patient that specifies amount and type of
food she must eat at each meal.
 Set a time for each meal.
 Identify patients elimination patterns.

12. Cont…
 Teach patients to keep journal to moniter high risk
situations that cue binging and purging behaviours .
 Encourage patients to recognized and verbalize her
feelings about her eating behaviour.
 Explain risk of laxative , emetic , and diuretic abuse.

13. SUMMARY

14. CONCLUSION

15. Thank you…