1. Feeding, Eating, and Elimination Disorders
Chapter 18
Feeding, Eating, and Elimination Disorders
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

2. Clinical Picture Anorexia nervosa Bulimia nervosa
Binge eating disorder
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

3. Etiology Biological factors Psychological factors
Genetics
Neurobiological
Psychological factors
Environmental factors
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

4. Anorexia Nervosa Nursing Process
Assessment
General assessment
Self assessment
Nursing diagnosis
Outcomes identification
Planning
Refeeding syndrome
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

5. Case Study
A 15-year-old is admitted to your unit with anorexia. You have completed your physical assessment of her.
What are some important biopsychosocial areas to assess?
Areas to be covered include the patient’s:
Perception of the problem
Eating habits
History of dieting
Methods used to achieve weight control (restricting, purging, exercising)
Value attached to a specific shape and weight
Interpersonal and social functioning
Mental status and physiological parameters
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

6. Anorexia Nervosa Interventions
Acute care
Psychosocial interventions
Pharmacological interventions
Integrative medicine
Health teaching and health promotion
Safety and teamwork
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

7. Advanced Practice Interventions
Psychotherapy
Individual therapy
Group therapy
Family therapy
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

8. Bulimia Nervosa Nursing Process
Assessment
General assessment
Self assessment
Nursing diagnosis
Outcomes identification
Planning
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

9. Bulimia Nervosa Interventions
Acute care
Teamwork and safety
Pharmacological interventions
Counseling
Health teaching and health promotion
Advanced practice interventions
Psychotherapy
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

10. Binge Eating Nursing Process
Assessment
General assessment
Self assessment
Nursing diagnosis
Outcomes identification
Planning
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

11. Binge Eating Interventions
Acute care
Psychosocial interventions
Pharmacological interventions
Health teaching and health promotion
Teamwork and Safety
Advanced practice interventions
Psychotherapy
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

12. Question 1
An adolescent female is brought to the school nurse after fainting during gym class. She is grossly underweight, wears baggy clothes, and has dry skin. She complains of feeling cold despite wearing two sweaters. To further assess for an eating disorder, the nurse should ask:
“Do you ever experience lost time?”
“When was your last menstrual period?”
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

13. Question 1 (Cont.) “Do you often wear heavy clothing in warm weather?”
“How long does it take you to fall asleep at night?”
Answer: B
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

14. Feeding and Elimination Disorders
Feeding disorders
Pica
Rumination disorder
Avoidant/restrictive food intake disorder
Elimination disorders
Enuresis
Encopresis
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

15. Audience Response Questions
Hypoalbuminemia in a patient with an eating disorder would produce which assessment finding?
Lanugo
Jaundice
Amenorrhea
Peripheral edema
ANS: D
Peripheral edema often results from deficits of the protein albumin.
REF: 346, 353
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

16. Audience Response Questions
An adolescent faints during gym class. She is grossly underweight, wears baggy clothes, and her skin is dry. To further assess for anorexia nervosa, the school nurse should ask
“Do you often wear heavy clothing in warm weather?”
“When was your last menstrual period?”
“Do you use any drugs or alcohol?”
“Do you ever lose lapses of time?”
ANS: B
Amenorrhea often accompanies anorexia nervosa.
REF: 346, 347
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.