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Mental Health Nursing II NURS 2310

Mental Health Nursing II NURS 2310. Unit 9 Eating Disorders. Anorexia Nervosa. Definition Prolonged loss of appetite; self-starvation with a disruption in metabolism due to inadequate calorie intake. Incidence & Population Affected Increased in the past 30 years

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Mental Health Nursing II NURS 2310

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  1. Mental Health Nursing IINURS 2310 Unit 9 Eating Disorders

  2. Anorexia Nervosa

  3. Definition Prolonged loss of appetite; self-starvation with a disruption in metabolism due to inadequate calorie intake. Incidence & Population Affected • Increased in the past 30 years • Affects approximately 1% of young women • Occurs predominantly in females aged twelve to thirty • Less than 10 percent of cases are males

  4. Etiology & Characteristics • Morbid fear of obesity • Gross distortion of body image; sees self as “fat” when obviously underweight • Preoccupation/obsession with food • hoarding or concealing food • preparing elaborate meals for others while severely restricting self • Refusal to eat; marked weight loss • May include extensive exercising • Physiological symptoms include amenorrhea, hypothermia, bradycardia, hypotension, edema, lanugo, and metabolic changes

  5. Diagnostic Criteria • Refusal to maintain body weight at or above a minimally normal weight for age and height • Intense fear of gaining weight or becoming fat, even though underweight • Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight • Amenorrhea

  6. Bulimia Nervosa

  7. Definition Excessive, insatiable appetite; episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time, followed by inappropriate compensatory behaviors to rid the body of the excess calories.

  8. Incidence & Population Affected • More prevalent than anorexia nervosa • Affects approximately 4% of young women • Onset occurs in late adolescence or early adulthood • Occurs mainly in populations with an abundant availability of food, and in which the ideal of beauty is thinness

  9. Etiology & Characteristics • Persistent overconcern with personal appearance • Weight fluctuations common due to alternating binges and fasts • Excessive vomiting and laxative/diuretic abuse may lead to problems with dehydration and electrolyte imbalances • Gastric acid in vomitus contributes to the erosion of tooth enamel • Individual may experience tears in the gastric or esophageal mucosa

  10. Diagnostic Criteria • Recurrent episodes of binge eating • Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise • The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months • Self-evaluation is unduly influenced by body shape and weight

  11. Obesity

  12. Definition Chronic disease defined by having a Body Mass Index (BMI) of more than 30. Incidence & Population Affected • 61% of the U.S. population age 20 or older are overweight; 27% are obese; 4.7% are morbidly obese • Affects black women more than white women, and white men more than black men • 6 times more prevalent among lower socioeconomic classes

  13. Etiology & Characteristics • May have a genetic component • Lifestyle factors; lack of physical activity • Leads to problems with hyperlipidemia, hyperglycemia, diabetes mellitus, osteoarthritis due to trauma to weight-bearing joints, angina and respiratory insufficiency due to increased workload of the heart and lungs • Food is considered a social outlet • Depression/low self-esteem • May involve binge-eating disorder

  14. Diagnostic Criteria (Binge-Eating Disorder) • Recurrent episodes of binge eating in which one does not feel in control of what/how much is being consumed • Binge-eating episodes are associated with • eating much more rapidly than normal • eating until feeling uncomfortably full • eating alone because of being embarrassed by how much one is eating • feeling depressed or guilty after overeating • Marked distress regarding binge eating • The binge eating occurs, on average, at least 2 days a week for 6 months

  15. Nutritional Deficits

  16. Electrolyte imbalances • Nutrient deficits • Malnutrition • Poor glucose control • Deficiency in vital fats • Vitamin deficiencies

  17. Treatment Modalities

  18. Education • Learning healthy eating patterns • Weight management • Nutrition education • Exercise program • Surgery • Individual therapy • Cognitive-behavioral therapy (CBT) • Coping with thoughts and feelings • Family therapy • Psychopharmacology • Antidepressants • Anxiolytics

  19. Milieu Therapy *Focuses on behavior modification • Changing maladaptive eating behaviors • Empowering client to take control of treatment • Contract for privileges based on weight gain or weight maintenance • Goals of therapy agreed upon by client and staff • System of rewards and privileges can be earned by client, who is given ultimate control • Client chooses whether or not to abide by the contract • Client is made accountable for choices and behaviors

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