Title: Nursing care for patients with eating disorders
1Nursing care for patients with eating disorders
2Eating Disorders
A collection of psychiatric conditions that
manifest psychological illness through abnormal
eating habits and body image Includes anorexia
nervosa, bulimia nervosa, binge eating,
orthorexia nervosa, pica and selective eating
disorder
http//vimeo.com/user638254/videos/sortdate
(www.nationaleating disorder.org, 2011)
3Statistics
- Eating disorders are grossly under diagnosed due
to the surrounding secretive and resistant habits - 90 of cases are female U.S. prevalence 10
million women and 1 million men - 40 of new diagnoses occur in females 15-19 years
old - Only 1/3 of people with anorexia nervosa and 6
of people with bulimia receive mental health
services - (www.nationaleating disorder.org, 2011)
4Eating Disorders Comorbid Diagnoses
- Borderline Personality Disorder
- Obsessive Compulsive Disorder and Obsessive
Personality Disorder - Depression
- Anxiety
- Body Dysmorphic Disorder
- Narcissistic Personality Disorder
- Addiction and Substance abuse
- Victim of Abuse or trauma
5Methods of Eating Disorders
- Persons with eating disorders may utilize
different methods as their illness evolves - Calorie reduction
- Excessive exercise
- Induced vomiting (mechanical or chemical)
- Misuse of laxatives, dieting pills, enemas,
diuretics - Insulin misuse
6- What does 300 calories look like?
7Anorexia Nervosa
- Seek to maintain a BMI lt18, most often with
calorie reduction - Ritualistic /analytical eating habits
- Preoccupation with weight/size and anxiety with
weight gain - Lifetime prevalence of 1 in women, 90 of cases
are female - Anorexia nervosa has a mortality rate of 20,
giving it the highest mortality rate of all
psychiatric disorders - 10 die within 10 years of diagnosis
- 35 fully recover
- (www.state.sc.us/dmh/anorexia/statistics.htm,
2011)
8Body Mass index
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10Bulimia Nervosa
- Engage in compulsory consumption of high calorie
foods during binge episodes often followed by
purging - Cyclic pattern of calorie restraint, excessive
intake and purging - Binge on high calorie, high sugar and high fat
foods - Binge-purge twice/week x 3 months per DSM 4
- Episodes occur in private, beyond volitional
control - Usually have a BMI gt18
- Episodes are often triggered by stressful events
and changes - (www.womenshealth.gov/faq/bulimia-nervosa.cfma,
2011)
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12Pro-Ana, Pro-Mia and Pro-Ed
- A n eating disorder community who collectively
deny the pathology of their habits, defend their
condition as a lifestyle choice and maintain
extreme thinness as a form of beauty - Thinspiration pictures
- http//www.bukisa.com/articles/381852_45-pro-ana-t
ips-and-tricks
13Assessment
- What would you include in your assessment?
- Questions?
- Measurements?
- Labs?
- Diagnostics?
14Medical Treatments
- Standard
- History height/weight, eating/dieting habits ,
body image, menstrual habits, stressors/coping - Labs CBC, chem panel, thyroid levels, estrogen,
albumin/prealbumin, urinanalysis, ABG - Diagnostics VS, EKG
- gt20 below BMI chest x-ray, 24hr creatinine
clearance, bone density scan, echocardiogram
(mitral valve prolapse) EEG, brain imaging - (www.nationaleatingdisorders.org/uploads/file/Scre
ening20for20Eating20Disorders20by20Primary20
Care20Physicians-2.pdf, 2011)
15Recovery Team
- Medical MD, psychiatrist
- Clinical psychologist/therapist, expressive
therapist - Social worker, case manager
- Nurse
- Dietician
- Teachers/School Liaison
16Recovery Environments
- Hospital Inpatient Acute physical problems
- Mental Health Inpatient Facility unstable
psychiatric problems, suicidal - Residential Facility structured living
environment - Intensive Outpatient several hours on most
weekdays - Outpatient weekly sessions
- Telehealth technology and telephone resources
- (www.eatingdisorderrecovery.com. 2011)
17Recovery Interventions
- Tube Feeding with consent
- Treat the compounding psychiatric condition
- Individual counseling, psychotherapy
- Group Therapy
- Family Therapy
- Support Groups
- Art/Expression Therapy, Culinary/Nutrition
Sessions - (www.eatingdisorderrecovery.com. 2011)
18References
- Eating Disorder Recovery (2011). Retrieved from
www.eatingdisorderrecovery.com. - National Eating Disorders Association (2011).
Retrieved from www.nationaleating disorder.org - Womens Health Information Center (2011)
Retrieved from www.womenshealth.gov