1. The client/caregiver can define eating disorders.
    1. Eating disorders are serious but treatable medical illnesses involving severe disturbances in eating behavior.
    2. The two main eating disorders are anorexia nervosa and bulimia nervosa.
    3. Denial of the problem is common. Families and friends may become involved to ensure medical help for the person suffering from eating disorders.
  2. The client/caregiver can list factors that increase the risk of an eating disorder.
    1. Girls and women are more likely to develop eating disorders.
    2. Patients are most common during teens and early 20s.
    3. Feelings of insecurity or an overly critical family may increase risk.
    4. Patients are more common in people with a close family member suffering from an eating disorder.
    5. People with depression, anxiety disorders, and obsessive-compulsive disorder have a higher risk. Some people with bulimia have impulse control issues.
    6. People who participate in highly competitive athletic activities have a greater risk.
  3. The client/caregiver can explain anorexia nervosa and its symptoms.
    1. Anorexia nervosa is a condition that results from self-imposed starvation.
    2. Symptoms of anorexia nervosa are
      • Loss of 20% to 40% of usual body weight
      • Intense fear of becoming obese
      • Preoccupation with food (avoiding food, picking out only a few foods to eat, weighing food to cut back size portions)
      • Body image disturbance
      • Misconceptions of physical status
      • Intake as low as 500 to 800 calories a day
      • Poor muscle tone
      • Self-esteem that is directly related to body weight or shape
      • After reaching puberty have infrequent or missing menstrual periods
      • Repeatedly check body weight
      • Use intense and compulsive exercise to maintain low weight
      • Excessive hair loss
  4. The client/caregiver can explain bulimia nervosa and its symptoms.
    1. Bulimia nervosa is when a person binges and purges.
    2. Binging is the consumption of large amounts of food in short periods of time. Binging can mean consuming as much as 5,000 to 20,000 calories a day.
    3. Purging is the intentional clearing of food from the body by
      • Vomiting (self-induced or use of Ipecac)
      • Abuse of laxatives or diuretics
      • Enemas
    4. Because of the cycle, they appear to be of normal weight.
    5. Symptoms of bulimia nervosa are
      • Body image disturbance
      • Much of the activity is done in secrecy
      • Weight determines self-esteem.
      • Sneaking food or lying about eating habits
      • Eating to relieve stress or depression
      • Perfectionism
      • Eating when not hungry
      • Repeated attempts at dieting or very strict dieting
  5. The client/caregiver can list the components of treatment.
    1. Nutrition education
    2. Psychotherapy
    3. Family counseling
    4. Medications
  6. The client/caregiver can list measures to manage and cope with eating disorders.
    1. General self-care measures to develop are
      1. Follow a regular schedule for meals.
      2. Stop eating when you are full, but not stuffed.
      3. Eat healthy, well-balanced meals.
      4. Take vitamin and mineral supplements as ordered by a physician.
      5. Exercise regularly, but use moderation.
      6. Take medications as ordered.
    2. Coping skills to break the self-destructive behaviors involved with eating disorders.
    3. Elevated uric acid
    4. Low blood glucose levels
    5. Erosion of enamel on teeth, increased cavities, and bleeding gums
    6. Esophageal perforations or lacerations (from induced vomiting)
    7. Aspiration pneumonia
    8. Death from cardiac arrest or electrolyte imbalance
      1. See your physician, counselor, or health care professional regularly.
      2. Improve self-esteem by getting involved in activities or groups you enjoy, and learn a new skill or hobby.
      3. Get help to improve family dynamics.
      4. Seek out support groups or supportive friends.
      5. Be realistic about healthy weight and body image.
  7. The client/caregiver can list possible complications of eating disorders.
    1. Heart conditions such as slow pulse, low blood pressure, electrocardiogram (EKG) abnormalities, and congestive heart failure
    2. Kidney stones or kidney failure
    3. Elevated uric acid
    4. Low blood glucose levels
    5. Erosion of enamel on teeth, increased cavities, and bleeding gums
    6. Esophageal perforations or lacerations (from induced vomiting)
    7. Aspiration pneumonia
    8. Death from cardiac arrest or electrolyte imbalance

Resources

National Eating Disorders Associationwww.nationaleatingdisorders.org
American Dietetic Associationwww.eatright.org
Nemours Foundation/Kids Health for Parentswww.kidshealth.org/parent/emotions/feelings/eating_disorders.html
National Mental Health Information Centerwww.mentalhealth.samhsa.gov/publications

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.Cohen, B. J., & Taylor, J. J. (2005). Memmler’s the human body in health and disease (10th ed.). Philadelphia: Lippincott Williams & Wilkins.Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott, Williams & Wilkins.Varcarolis, E. M. (2006). Manual of psychiatric nursing care plans. St. Louis: Saunders Elsevier.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com

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