Life-threatening eating disorder

characterized by :
clients refusal or inability 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,

steadfast refusal to
acknowledge seriousness of
the problem
Body weigh is 85% less than
expected of their height and
weight
begins between 14 to 18 years
of age
BINGE EATING consuming a
large amount of food in a
period of 2 hours.

PURGING eliminate food by
self-induced vomiting, misuse
of laxatives, enemas,
diuretics.
Assessment Findings
fear of gaining weight or
becoming fat even when
severely underweight
body image disturbance
amenorrhea
depressive symptoms such as
depressed mood, social
withdrawal, irritability ,
insomnia, anxious and worried
preoccupation with
thoughts of food
feelings of ineffectiveness
inflexible thinking
strong need to control
environment
limited spontaneity and
overly restrained emotional
expression
complaints of constipation and
abdominal pain
cold intolerance
lethargy
emaciation
hypotension, hypothermia,
bradycardia
hypertrophy of salivary glands
elevated BUN
electrolyte imbalances
leukopenia and mild anemia
elevated liver function studies
perfectionists, eager to please,
dependable
labile mood
psychopharmacology
amitriptyline (Elavil)
promote weight gain
cyproheptadine (Periactin)
Olanzapine (Zyprexa)-
antipsychotic and weight
gain
Flouxetine (Prozac)=-
prevent relapse


eating disorder
characterized by recurrent
episodes of binge eating ( at
least twice a week for 3
months) followed by purging,
fasting, or excessively
exercising
binging and purging is
precipitated by strong
emotions followed by guilt,
remorse, shame, or self-
contempt
weight is in the normal range
begins in late adolescence or
early adulthood (18 or 19)
aware that eating behavior
is pathologic and hide it
from others
store foods in cars, desks,
secret locations around the
house
50% recover fully
ASSESSMENT FINDINGS
recurrent episodes of binge
eating
compensatory behavior
such as vomiting, misuse of
laxatives, diuretics, enemas
self-evaluation overly
influenced by body shape
and weight
usually within normal
weight range
restriction of total calorie
consumption between
binges
depressive and anxiety
symptoms
possible substance use
involving stimulants or
alcohol
loss of dental enamel
chipped, ragged appearance
of teeth
increased dental caries
menstrual irregularities
dependence on laxatives
esophageal tears
fluid and electrolyte
abnormalities
metabolic alkalosis
(vomiting) or acidosis
(diarrhea)
psychopharmacology
desipramine (Norpramin)
Imipramine (Tofranil)
Amitryptiline (Elavil)
Nortryptiline (Pamelor)
Phenelzine (Nardil)
Flouxetine (Prozac)
NURSING CARE FOR BOTH
Limit dietary intake to caloric
requirements.
Reduce episodes of binging and purging.
Consult with nutritionist to determine
adequate dietary regime.
Do not focus on eating or weight loss
instead shift focus to emotional issues.
Encourage verbalization of feelings.
Keep client under close observation to
prevent purging.
Erosion of the teeth
enamel