Eating Disorders PDF

11/16/23, 11:28 AM Realizeit for Student Summary Anorexia nervosa is a life-threatening eating disorder differentiated by the client’s restriction of nutritional intake essential to maintain a minimally normal body weight, intense fear of gaining weight or becoming fat, significantly disturbed per...

11/16/23, 11:28 AM Realizeit for Student Summary Anorexia nervosa is a life-threatening eating disorder differentiated by the client’s restriction of nutritional intake essential to maintain a minimally normal body weight, intense fear of gaining weight or becoming fat, significantly disturbed perception of the shape or size of the body, and steadfast inability or refusal to acknowledge the seriousness of the problem or even that one exists. Bulimia nervosa, often simply called bulimia, is an eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors to avoid weight gain, such as purging, fasting, or excessively exercising. For clients with anorexia, about 30% to 50% achieve full recovery, while 10% to 20% remain chronically ill. Compared to the general population, clients with anorexia are six times more likely to die from medical complications or suicide. Clients with the lowest body weights and longest durations of illness tended to relapse most often and have the poorest outcomes. Major lifethreatening complications that indicate the need for hospital admission include severe fluid, electrolyte, and metabolic imbalances; cardiovascular complications; severe weight loss and its consequences; and risk for suicide. Clients with bulimia are aware that their eating behavior is pathologic, and they go to great lengths to hide it from others. They may store food in their cars, desks, or secret locations around the house. They may drive from one fast-food restaurant to another, ordering a normal amount of food at each but stopping at six places in 1 or 2 hours. Such patterns may exist for years until family or friends discover the client’s behavior or until medical complications develop for which the client seeks treatment. Most clients with bulimia are treated on an outpatient basis. A few nursing interventions for clients with an eating disorder may include: Assist the client in changing stereotypical beliefs, helping the client deal with body image issues, recognize benefits of a more near-normal weight, assist in viewing self in ways not related to body image, and/or identify personal strengths, interests, and talents. Nurses can educate parents, children, and young people about strategies to prevent eating disorders. Important aspects include realizing that the “ideal” figures portrayed in advertisements and magazines are unrealistic, developing realistic ideas about body size and shape, resisting peer pressure to diet, improving self-esteem, and learning coping strategies for dealing with emotions and life issues. Anorexia nervosa is a life-threatening eating disorder characterized by body weight less than below minimum expectations, an intense fear of being fat, a severely distorted body image, and refusal to eat or binge eating and purging. Bulimia nervosa is an eating disorder that involves recurrent episodes of binge eating and compensatory behaviors such as purging, using laxatives and diuretics, or exercising excessively. Of clients with eating disorders, 90% are females. Anorexia begins between the ages of 14 and 18 years, and bulimia begins around age 18 or 19. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXP1mimyVQOPOHLAvYAjZdL7GFyh%2bBfe9WR6sPHV… 1/3 11/16/23, 11:28 AM Realizeit for Student Many neurochemical changes are present in individuals with eating disorders, but it is uncertain whether these changes cause or are a result of the eating disorders. Individuals with eating disorders feel unattractive and ineffective and may be poorly equipped to deal with the challenges of maturity. Societal attitudes regarding thinness, beauty, desirability, and physical fitness may influence the development of eating disorders. Severely malnourished clients with anorexia nervosa may require intensive medical treatment to restore homeostasis before psychiatric treatment can begin. Family therapy is effective for clients with anorexia; CBT is most effective for clients with bulimia. Interventions for clients with eating disorders include establishing nutritional eating patterns, helping the client identify emotions and develop coping strategies not related to food, helping the client deal with body image issues, and providing client and family education. Focus on healthy eating and pleasurable physical exercise; avoid fad or stringent dieting. Parents must become aware of their own behavior and attitudes and the way they influence children. An obsession involves an uncontrollable desire to dwell on a thought or a feeling; a compulsion involves repeated performance of some act to relieve the fear and anxiety associated with an obsession. Obsessive–compulsive disorder (OCD) is characterized by obsessions or compulsions that are severe enough to be time consuming (e.g., take more than an hour per day), cause marked distress, or impair the person’s ability to function in usual activities or relationships. The compulsive behavior provides some relief from anxiety but is not pleasurable. When patients resist or are prevented from performing the compulsive behavior, they experience increasing anxiety and often abuse alcohol or antianxiety, sedative-type drugs in the attempt to relieve anxiety. Obsessive– compulsive disorder (OCD) was previously classified as an anxiety disorder due to the intermittent or ongoing extreme anxiety that people experience. However, it varies from other anxiety disorders in significant ways. Certain disorders characterized by repetitive thoughts and/or behaviors, such as OCD, can be grouped together and described in terms of an obsessive–compulsive spectrum. The spectrum approach includes repetitive behaviors of various types: self-soothing behaviors, such as trichotillomania, dermatillomania, or onychophagia; reward-seeking behaviors, such as hoarding, kleptomania, pyromania, or oniomania; and disorders of body appearance or function, such as body dysmorphic disorder (BDD). Depending on the particular obsession and its accompanying compulsions, clients have varying symptoms. A few nursing examples for clients suffering from OCD could include: Emphasize medication compliance as an important part of treatment, discuss necessary behavioral techniques for managing anxiety and decreasing prominence of obsessions, and/or tolerating anxiety is uncomfortable but not harmful to health or well-being. OCD involves recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses (obsessions) and ritualistic or repetitive behaviors or mental acts (compulsions) carried out to eliminate the obsessions or to neutralize anxiety. Rituals or compulsions may include checking, counting, washing, scrubbing, praying, chanting, touching, rubbing, ordering, or other repetitive behaviors. OCD can start in childhood and often lasts into adulthood. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXP1mimyVQOPOHLAvYAjZdL7GFyh%2bBfe9WR6sPHV… 2/3 11/16/23, 11:28 AM Realizeit for Student OCD is a chronic progressive disease. Symptoms wax and wane over time, increasing during periods of stress. Disorders related to OCD include dermatillomania, trichotillomania, onychophagia, kleptomania, oniomania, BDD, body identity disorder, and hoarding. Etiology of OCD is not specifically known but includes genetic influences and environmental experiences. OCD is universal across countries with some variation in symptoms. Treatment includes medications, SSRIs, and behavioral therapy, specifically exposure and response prevention. Effective nursing interventions include therapeutic communication, teaching relaxation and behavioral techniques, following a daily routine, and client and family education about OCD and its treatment. Onset of OCD after age 50 is rare. The incidence of hoarding increases with age. Practicing anxiety management and behavioral techniques daily is important for positive long-term outcomes. Anti-anxiety benzodiazepine medications are therefore used for symptomatic management due to the anxiety component of OCD. Additional treatment includes selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine inhibitors (SNRIs) SSRIs, and second-generation “atypical” antipsychotics. SSRIs include fluvoxamine [Prozac/Luvox] and sertraline [Zoloft]. SNRIs include venlafaxine [Effexor]. Antidepressant medications work by altering the concentration of neurotransmitters in the brain. The antidepressant drugs counteract the effects of neurotransmitter deficiencies in three primarily different ways: by inhibiting the effects of MAO, leading to increased NE or 5HT in the synaptic cleft; by blocking the reuptake of neurotransmitters by the releasing nerve, leading to increased neurotransmitter levels in the synaptic cleft; or the medication may regulate receptor sites and the breakdown of neurotransmitters, leading to an accumulation of neurotransmitter in the synaptic cleft. The second-generation “atypical” antipsychotics each work a little differently to assist with OCD symptoms and the true action is not totally understood. However, their adverse effects are less and therefore, adherence to medication regimen is increased. The second-generation “atypical” antipsychotics include olanzapine [Zyprexa], risperidone [Risperdal], and Quetiapine [Seroquel, Seroquel XR]. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXP1mimyVQOPOHLAvYAjZdL7GFyh%2bBfe9WR6sPHV… 3/3