Chapter 18 Feeding Eating and Elimination Disorders Copyright

Chapter 18 Feeding, Eating, and Elimination Disorders Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

Clinical Picture Anorexia nervosa Bulimia nervosa Binge eating disorder Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 2

Etiology Biological factors Genetics Ø Neurobiological Ø Psychological factors Environmental factors Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 3

Anorexia Nervosa Nursing Process Assessment General assessment Ø Self assessment Ø Nursing diagnosis Outcomes identification Planning Ø Refeeding syndrome Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 4

Case Study A 15 -year-old is admitted to your unit with anorexia. You have completed your physical assessment of her. What are some important biopsychosocial areas to assess? Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 5

Anorexia Nervosa Interventions Acute care Psychosocial interventions Ø Pharmacological interventions Ø Integrative medicine Ø Health teaching and health promotion Ø Safety and teamwork Ø Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 6

Advanced Practice Interventions Psychotherapy Individual therapy Ø Group therapy Ø Family therapy Ø Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 7

Bulimia Nervosa Nursing Process Assessment General assessment Ø Self assessment Ø Nursing diagnosis Outcomes identification Planning Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 8

Bulimia Nervosa Interventions Acute care Teamwork and safety Ø Pharmacological interventions Ø Counseling Ø Health teaching and health promotion Ø Advanced practice interventions Ø Psychotherapy Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 9

Binge Eating Nursing Process Assessment General assessment Ø Self assessment Ø Nursing diagnosis Outcomes identification Planning Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 10

Binge Eating Interventions Acute care Psychosocial interventions Ø Pharmacological interventions Ø Health teaching and health promotion Ø Teamwork and Safety Ø Advanced practice interventions Ø Psychotherapy Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 11

Question 1 An adolescent female is brought to the school nurse after fainting during gym class. She is grossly underweight, wears baggy clothes, and has dry skin. She complains of feeling cold despite wearing two sweaters. To further assess for an eating disorder, the nurse should ask: A. “Do you ever experience lost time? ” B. “When was your last menstrual period? ” Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 12

Question 1 (Cont. ) C. “Do you often wear heavy clothing in warm weather? ” D. “How long does it take you to fall asleep at night? ” Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 13

Feeding and Elimination Disorders Feeding disorders Pica Ø Rumination disorder Ø Avoidant/restrictive food intake disorder Ø Elimination disorders Enuresis Ø Encopresis Ø Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 14

Audience Response Questions 1. Hypoalbuminemia in a patient with an eating disorder would produce which assessment finding? A. Lanugo B. Jaundice C. Amenorrhea D. Peripheral edema Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 15

Audience Response Questions 2. An adolescent faints during gym class. She is grossly underweight, wears baggy clothes, and her skin is dry. To further assess for anorexia nervosa, the school nurse should ask A. “Do you often wear heavy clothing in warm weather? ” B. “When was your last menstrual period? ” C. “Do you use any drugs or alcohol? ” D. “Do you ever lose lapses of time? ” Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc. 16