Eating disorders 2(1)

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Eating disorders 2(1)

  1. 1. NUR 448 Eating Disorders
  2. 2. Theoretical Perspectives <ul><li>Historical </li></ul><ul><li>Cultural </li></ul><ul><li>Psychoanalytic </li></ul><ul><li>Family systems </li></ul><ul><li>Behavioral </li></ul><ul><li>Feminist </li></ul><ul><li>Physiologic </li></ul>
  3. 3. Psychological factors <ul><li>Developmental level </li></ul><ul><li>Personality component </li></ul><ul><li>Affective component </li></ul><ul><li>Interaction with culture or socio-economic class </li></ul>
  4. 4. Major disorders <ul><li>Anorexia nervosa </li></ul><ul><li>Bulimia nervosa </li></ul><ul><li>Binge eating disorder </li></ul><ul><li>Morbid obesity </li></ul>Anorexia Nervosa
  5. 5. Anorexia nervosa <ul><li>Refusal to maintain body weight </li></ul><ul><li>Weight less than 85% of expected </li></ul><ul><li>Intense fear of gaining weight </li></ul><ul><li>Amenorrhea for three months </li></ul><ul><li>Lanugo, dysrhythmias, anxiety, </li></ul><ul><li>Upper SEC </li></ul><ul><li>Types </li></ul><ul><ul><li>restricting type </li></ul></ul><ul><ul><li>binge-eating/purging type </li></ul></ul>
  6. 6. Types <ul><li>Restricting –refusal to eat </li></ul><ul><li>Binge-eating purging- eating small amount s of food and purging </li></ul>
  7. 7. Signs <ul><li>Laboratory </li></ul><ul><ul><li>Decreased BUN </li></ul></ul><ul><ul><li>Hypokalemia </li></ul></ul><ul><ul><li>Hyponatremia </li></ul></ul><ul><ul><li>Hypochloremia </li></ul></ul><ul><ul><li>Increased liver function tests </li></ul></ul><ul><li>Physical </li></ul><ul><ul><li>Bradycardia </li></ul></ul>
  8. 8. Bulimia nervosa <ul><li>Recurrent episodes of binge eating </li></ul><ul><ul><li>eating within a discrete period of time a larger than normal amount of food </li></ul></ul><ul><ul><li>lack of control over eating </li></ul></ul><ul><li>Recurrent compensatory behavior </li></ul><ul><ul><li>vomiting, misuse of diuretics, laxatives, enemas, fasting or exercise </li></ul></ul><ul><ul><ul><li>Purging type </li></ul></ul></ul><ul><ul><ul><li>Non-purging type </li></ul></ul></ul>
  9. 9. Types <ul><li>Purging –induced vomiting laxatives diuretics </li></ul><ul><li>Non-purging-ingesting large amounts of food followed by abstinence or excessive exercise </li></ul>Bulimia Nervosa
  10. 10. Signs <ul><li>Laboratory </li></ul><ul><ul><li>Hypokalemia </li></ul></ul><ul><ul><li>Hyponatremia </li></ul></ul><ul><ul><li>Hypochloremia </li></ul></ul><ul><ul><li>Physical </li></ul></ul><ul><ul><li>Loss of tooth enamel </li></ul></ul><ul><ul><li>Enlarged parotid glands </li></ul></ul>
  11. 11. Binge eating disorder <ul><li>Recurrent episodes of binge eating </li></ul><ul><li>Rapid eating, eating until uncomfortable </li></ul><ul><li>Eating alone, being disgusted with eating </li></ul><ul><ul><li>eating within a discrete period of time a larger than normal amount of food </li></ul></ul><ul><ul><li>lack of control over eating </li></ul></ul>
  12. 12. Morbid Obesity <ul><li>Eating massive amounts of food for long periods of time </li></ul><ul><li>Worry over money to buy food </li></ul><ul><li>Obsession with food </li></ul><ul><li>Clinical depression when on a weight loss program </li></ul>
  13. 13. Nursing Diagnoses <ul><li>Individual </li></ul><ul><ul><li>Individual coping ineffective </li></ul></ul><ul><ul><li>Body image disturbance-view themselves as fat </li></ul></ul><ul><ul><li>Disturbance in self esteem </li></ul></ul><ul><li>Family </li></ul><ul><ul><li>Enmeshed </li></ul></ul><ul><ul><li>Over protectiveness </li></ul></ul><ul><ul><li>Conflict avoidance </li></ul></ul>
  14. 14. Anorexia-Nursing intervention <ul><li>Positive reinforcement </li></ul><ul><li>Focus is on feelings and growth </li></ul><ul><li>Developmental issues </li></ul><ul><li>Control issues **** </li></ul><ul><li>Supportive life saving measures as necessary </li></ul>
  15. 15. Bulimia-Nursing intervention <ul><li>Positive reinforcement </li></ul><ul><li>Control impulsiveness </li></ul><ul><li>Assist with not acting out </li></ul><ul><li>Safety measures as needed </li></ul>
  16. 16. Morbid obesity-Nursing intervention <ul><li>Positive reinforcement </li></ul><ul><li>Exercise program </li></ul><ul><li>Long term supportive psychotherapy </li></ul><ul><li>Biopsychology support </li></ul>Morbid Obesity
  17. 17. Questions <ul><li>What are the age characteristics of people with eating disorders? </li></ul><ul><li>What are the cultural issues of eating disorders? </li></ul><ul><li>What is a culture bound syndrome? </li></ul>

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