Concept Map Anorexia Nervosa.docx PDF

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Summary

NURS 2000EveningsDx #1: Risk for Chronic Low Self EsteemInterventions: -Assess psychological status -Provide positive reinforcement -Use therapeutic communication skills to develop a trusting relationship. -Enlist family participation in care, as appropriate. -Refer the patient to community resource...

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NURS 2000Evenings Topic: Anorexia Nervosa

S/S: -Fear of gaining weight or becoming fat. -Disturbances in self perceived weight & shape (body dysmorphia) -Preoccupied with food & rituals; always hungry but rarely eats. -Low heart rate (30-40s) -Excessive physical activity

Pathophysiology: Persistent energy intake restriction leading to significantly low body weight in context of age, sex, developmental path, and physical health. Mostly commonly seen in early adolescence.

Labs/Tests Findings: -Hypokalemia -Anemia -Increased liver enzyme levels -Hypoalbuminemia -Elevated cholesterol -Elevated blood urea nitrogen -Abnormal thyroid function test -Decreased bone density -Abnormal glucose test results -ECG changes -metabolic alkalosis (related to self-induced vomiting) -metabolic acidosis (related to laxative abuse)

Medications: -Rehydration therapy (IV or PO) -High calorie/protein foods (to catch up) -Electrolyte replacement (Pedialyte if PO) -NG Tube if necessary (Meals not completed within 30 minutes, a feeding with be administered for noncompliance)

Dx #1: Risk for Chronic Low Self Esteem

Patient/Family Education: -Educate patient on Interventions: the risks on her body if -Assess psychological status she continues with -Provide positive reinforcement inadequate nutrition. -Use therapeutic communication skills to develop a trusting relationship. -Refer patient/family -Enlist family participation in care, as appropriate. to community support -Refer the patient to community resources available to help meet his/her health care groups. needs. -Involve Psych to help -Obtain social services/mental health services consult decide if the patient -Explore perceived discrepancies and concerns; provide clarification, as appropriate. meets requirements for any Dx #2: Risk for Disturbed Personal Identity inpatient/outpatient programs that would Interventions: be beneficial. -Assess for presence of risk factors contributing to symptoms. -Involve dietary to -Assist the patient in identifying & using positive coping behaviors. help them understand -Discuss behavioral expectations & reinforce positive behaviors. daily nutritional -Refer to community support groups. needs, and how to References: -Use therapeutic communication skills to develop a-ATI trusting relationship with the properly RN Mental Health Nursing, Chapter 19 balance a patient. -Lippincott Advisor for Education diet. -Help patient identify strengths & weaknesses -https://www.nationaleatingdisorders.org/learn/by-eating-Administer medications as prescribed. disorder/anorexia -Obtain mental health/social service consults.

- https://www.nationaleatingdisorders.org/blog/dealing-body-

Dx #3: Imbalanced Nutrition: Less than body requirements image-concerns-during-spring-break Interventions: -Assess the patient’s food preferences and dietary history. -Assess patient’s ability to orally intake food; assist with meals if necessary. -Monitor intake & output. -Monitor caloric intake as indicated. -Offer small frequent meals as necessary. -Monitor lab values as necessary. -Administer medications & supplements as ordered and monitor for effect....