(Exam 4) Eating and Feeding Disorders

what are our eating disorders (3)

- anorexia nervosa

- bulimia nervosa

- binge-eating disorder

what are eating behaviors (2)

- eating behaviors influenced by culture, family, and social influence

- habits when it comes to eating (either healthy or unhealthy)

what are healthy eating behaviors (4)

- eats when hungry

- eats intentionally and with purpose

- stops eating when satisfied/full

- positive body image

what are unhealthy eating behaviors

habits that lead to our ED diagnoses

what else to know about eating behaviors (2)

- influenced by culture, family, and social influence

- eating disorders represent a multidimensional set of sx and behaviors occurring along a spectrum

what are the dx criteria for anorexia nervosa (5)

- restriction of calorie intake leading to SIGNIFICANTLY LOW BODY WEIGHT (LOW BMI!!)

- body weight has a huge influence on self-evaluation for the client

- disturbance in how body weight/shape is experienced

- intense fear of gaining weight

- denial of the seriousness of low body weight

what are the two subcategories for anorexia nervosa (2)

restricting type: does not engage in binge-purge episodes

- weight loss through fasting and/or excessive exercise

binge-eating/purging type: engages in binge-eating or purging behavior

- self-induced vomiting, laxatives, diuretics, enemas to lose weight

what are some S/S of anorexia nervosa (11)

- low weight

- distorted body image

- cold extremities/lanugo

- peripheral edema

- muscle weakening

- amenorrhea

- hypothermia

- bradycardia/hypoTN

- constipation

- metabolic changes

- abnormal lab values

what is the nursing process for anorexia nervosa (5)

establishing more adaptive eating patterns

- weight restoration: daily meal plan and caloric intake

- highly structured, precise meal times

- observation before and after meals; monitoring bathroom trips

- monitor weight: weigh in gown, check urine specific gravity

- monitor movement: parameters for exercise

what is the dx criteria for bulimia nervosa (5)

BMI is typically in the normal range

- eating, in a discrete period (2-hour period), a large amount of food

- sense of lack of control, overeating during the episode

- recurrent, inappropriate, compensatory behaviors to prevent weight gain

- binge eating & compensatory behaviors occur at least once a week for 3 months

- self-evaluation is influenced by body shape and weight

what are the S/S of bulimia nervosa (9)

- normal BMI / slightly low weight

- dental caries, tooth erosion

- parotid swelling

- calluses (russell sign)

- muscle weakening

- peripheral edema

- electrolyte imbalance (hypokalemia/natremia

- cardiovascular abnormalities

- seizure (vomiting lowers threshold)

what is the nursing process for bulimia nervosa (4)

same for anorexia nervosa

- highly structured, precise meal times

- observation before and after meals; monitoring bathroom trips

- monitor weight: weigh in gown, check urine specific gravity

- monitor movement: parameters for exercise

what is the dx criteria for binge eating disorder (5)

BMI is usually high

- eating, in a discrete period (2 hours), a large amount of food

- sense of lack of control; over-eating

- binge eating occurs at least once a week for 3 months

- marked distress regarding binge eating

- no recurrent, inappropriate, or compensatory behaviors

what else is binge episodes associated with (6)

- eating more rapidly than normal

- eating large amount of food when not hungry

- eating until uncomfy full

- eating when not hungry

- eating alone, embarrassed by how much one is eating

- feeling disgusted, depressed, or very guilty

what is the nursing process with binge eating disorder (5)

- binge eating is not about food; more with emotional coping

- binge eating can cause gastrointestinal problems (heartburn, dysphagia, abdominal pain)

- care plan = focus on rebuilding daily intake, balancing frequency and volume

- focus on healthy movement and physical activity at slow pace

- obesity = risk for DM, HTN, heart disease

what are nursing dx for eating disorders (8)

- imbalanced nutrition

- fluid imbalance

- impaired body image

- electrolyte imbalance

- anxiety

- ineffective denial

- low self-esteem

- impaired coping

what are the interventions for the management of eating disorders (8)

- VS & daily weight

- monitor intake, exercise, purging

- structured meals, observation after eating

- hospitalization, nutritional therapy as needed

- establish a healthy dietary plan, avoid caffeine

- teach relaxation techniques

- cognitive restructuring

- pharmacotherapy

what is the pharmacotherapy for eating disorders (3)

- no FDA approved medication for anorexia

- fluoxetine (Prozac) SSRI = only FDA approved for bulimia

- lisdexamfetamine (Vyvanse) = stimulant approved for binge-eating disorder

what medication is contraindicated with eating disorders

buproprion (Wellbutrin) contraindicated with bulimia!!

--> increased seizure risk!

what are the psychological therapies for eating disorders (3)

- family-based treatment: more effective than individual therapy for anorexia

- CBT: first-line treatment for bulimia

- CBT, DBT, and IPT are all associated with reducing binge frequency

what is the evaluation for eating disorders (7)

- VS, BP, and labs within normal limits

- verbalizes importance of adequate nutrition & fluid intake

- demonstrates techniques for anxiety reduction

- verbalizes ways to reduce feelings of powerlessness

- express less preoccupation w/ own appearance

- demonstrates adaptive eating behaviors

- established a healthy pattern of eating for weight control

what are the overviews of feeding disorders (3)

- multiple etiologies, often associated with developmental delays of childhood

- may result in significant nutritional deficiencies; can be fatal

- treatment: behavioral intervention, aimed to increase appropriate food consumption

what are the three feeding disorders

- Pica

- Rumination disorder

- avoidant/restrictive food intake disorder

what is Pica

Ingestion of substances that have no nutritional value, like dirt or paint

what is rumination disorder

undigested food being returned to the mouth; it is then rechewed and re-swallowed, or spit out

what is avoidant/restrictive food intake disorder

food avoidance; may be related to strong dislikes related to the sensory qualities of food