Chapter 18

Feeding, Eating, and Elimination Disorders

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Anorexia nervosa Bulimia nervosa Binge eating disorder

Clinical Picture

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Biological factors Genetics Neurobiological

Psychological factors Environmental factors

Etiology

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Assessment General assessment Self assessment

Nursing diagnosis Outcomes identification Planning

Refeeding syndrome

Anorexia Nervosa Nursing Process

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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?

Case Study

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Acute care Psychosocial interventions Pharmacological interventions Integrative medicine Health teaching and health promotion Safety and teamwork

Anorexia Nervosa Interventions

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Psychotherapy Individual therapy Group therapy Family therapy

Advanced Practice Interventions

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Assessment General assessment Self assessment

Nursing diagnosis Outcomes identification Planning

Bulimia Nervosa Nursing Process

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Acute care Teamwork and safety Pharmacological interventions Counseling Health teaching and health promotion

Advanced practice interventions Psychotherapy

Bulimia Nervosa Interventions

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Assessment General assessment Self assessment

Nursing diagnosis Outcomes identification Planning

Binge Eating Nursing Process

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Acute care Psychosocial interventions Pharmacological interventions Health teaching and health promotion Teamwork and Safety

Advanced practice interventions Psychotherapy

Binge Eating Interventions

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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:

A.“Do you ever experience lost time?”

B.“When was your last menstrual period?”

Question 1

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C.“Do you often wear heavy clothing in warm weather?”

D.“How long does it take you to fall asleep at night?”

Question 1 (Cont.)

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Feeding disorders Pica Rumination disorder Avoidant/restrictive food intake disorder

Elimination disorders Enuresis Encopresis

Feeding and Elimination Disorders

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1. Hypoalbuminemia in a patient with an eating disorder would produce which assessment finding?

A. Lanugo

B. Jaundice

C. Amenorrhea

D. Peripheral edema

Audience Response Questions

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2. 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

A. “Do you often wear heavy clothing in warm weather?”

B. “When was your last menstrual period?”

C. “Do you use any drugs or alcohol?”

D. “Do you ever lose lapses of time?”

Audience Response Questions

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