Eating Disorders NURS2221 – Complex Mental Health and Recovery

Flashcards covering the pathophysiology, diagnoses, treatments, comorbidities, and nursing implications for eating disorders based on the provided lecture notes.

Pathophysiology of Eating Disorders

Not well understood; evidence suggests multicausal pathogeneses involving environmental, nutritional, and biological aspects. Malnutrition may also maintain the disorder.

Anorexia Nervosa

Characterised by restriction of energy intake leading to body weight less than the minimal normal, intense fear of gaining weight, persistent behaviours to counteract weight gain, and a disturbance in the evaluation of one’s own body weight or shape. Can be restrictive type or binge eating/purging.

Bulimia Nervosa

Recurrent episodes of binge eating, recurrent compensatory behaviours to prevent weight gain, and self-evaluation unduly influenced by body shape and weight, without any features of Anorexia Nervosa.

Binge Eating Disorder

Recurrent episodes of binge eating, eating rapidly until uncomfortably full, eating even when not hungry, eating alone due to embarrassment, and feelings of disgust or guilt. A diagnosis is excluded if associated features of Anorexia Nervosa or Bulimia Nervosa are present.

Eating Disorder Treatments

Include psychological therapies, dietary advice, pharmacological treatments, and a strong consideration for physical health.

Comorbidities with Eating Disorders

Include comorbid mental health problems (e.g., depression, anxiety, suicidality, sleep disturbances), malnutrition (e.g., undernutrition, dehydration, specific deficiencies), and physical health consequences (e.g., GI tract problems, cardiovascular problems, osteoporosis).

Physical Comorbidities of Bulimia Nervosa

Issues with dental health, electrolyte abnormalities, cardiac complications, and gastrointestinal complications.

Physical Comorbidities of Binge Eating Disorder

Obesity, Type 2 diabetes, cardiovascular disease, and some cancers.

Physical Comorbidities of Anorexia Nervosa

Low bone mineral density, arthritis, osteopenia, osteoporosis, cardiovascular abnormalities, renal injury, hypokalaemia, gastroparesis, and motility issues throughout the GI tract.

Re-Feeding Syndrome (RFS)

Complications due to increased caloric intake, which can lead to electrolyte imbalances with the risk of death. Diagnosed by a significant decrease in serum phosphorus, potassium, and/or magnesium levels within 5 days of reinitiating or substantially increasing energy provision.

ASPEN criteria for RFS diagnosis

Proposed by the American Society for Parenteral and Enteral Nutrition, includes a decrease in serum phosphorus, potassium, and/or magnesium levels by 10-20% (mild), 20-30% (moderate), or >30% (severe) and/or organ dysfunction, occurring within 5 days of reinitiating or increasing energy provision.

Comprehensive Treatment Strategy for Eating Disorders

Involves psychotherapies, medications, dietary counselling, coping skills training, and vigilant monitoring of physical health and comorbidities.

Key Physical Health Monitoring Parameters for Eating Disorders

Weight, height (if first attendance), BMI, heart rate (pulse rate), sitting/standing blood pressure, temperature, blood tests, and ECGs.

Unhelpful Aspects of Mental Health Nursing in Eating Disorders (from consumer perspective)

Negative staff attitudes, being weighed, recording food intake, lack of individualised care, symptoms dismissed as unimportant, and overemphasis on weight and food.

Helpful Approaches in Mental Health Nursing for Eating Disorders

Utilising a multidisciplinary approach, clear treatment plans for consistency, regular weights, recording food intake, person-centred care, engaging in other activities/conversations focusing beyond food, and treating/monitoring any comorbidities.