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Nursing Interventions for Anorexia Nervosa - Mental Disorder Patients

Anorexia nervosa is an eating disorder that involves an inability to stay at the minimum body weight considered healthy for the person's age and height.

Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may use extreme dieting, excessive exercise, or other methods to lose weight.


Causes

The exact causes of anorexia nervosa are unknown. Many factors probably are involved. Genetics and hormones may play a role. Social attitudes that promote unrealistically thin body types may also contribute.

More and more evidence points away from the idea that conflicts within a family may contribute to this or other eating disorders. Most mental health organizations no longer support this theory.

Risk factors include:

* Being a perfectionist
* Feeling increasing concern about, or attention to, weight and shape
* Having eating and digestive problems during early childhood
* Having a mother or father with anorexia or addictions
* Having parents who are concerned about weight and weight loss
* Having a negative self-image and a high level of negative feelings in general
* Undergoing a stressful life change, such as a new job or move, or events such as rape or abuse

Anorexia usually begins in adolescence or young adulthood. It is more common in females, but may also be seen in males. The disorder is seen mainly in Caucasian women who are high academic achievers and who have a goal-oriented family or personality.
www.nlm.nih.gov

Nursing Diagnosis for Anorexia Nervosa


Expected Outcomes:
  • Expressing understanding of nutritional needs
  • Establish a diet with adequate caloric intake to obtain the ideal body weight
  • Indicating weight gain in the range expected
Nursing Interventions for Anorexia Nervosa:

1. Determine the minimum weight goals and daily nutritional needs.
R: Malnutrition is a condition that changes the natural feelings that cause depression and agitation as well as affect cognitive function / decision-making. Improvements in nutritional status improve security thinking, and psychological work can begin.

2. Involve the client with a team in managing / implementing behavior modification programs. Give rewards for appropriate weight gain is determined on an individual basis; ignore the weight loss.
R: Providing a structured meal stimulation because the client is made to control the choice. Behavior modification may be effective only in cases of mild or penungkatan weight in the short term.

3. Use a consistent approach. Sitting with a client when eating; give or take food without persuasion and / or comments. Give a pleasant environment and record food intake.
R: The client detects the interest and reaction to pressure. Any comments which may appear as a force to focus on food. If a staff member to respond to it consistently, the client can begin to trust the response. An area when the client feels train strength and control, and he may experience guilt or to rebel if forced to eat. Structuring of time eating and reduce the discussion of food will lower the client's efforts to survive and avoid manipulative demand.

4. Create a selective menu and ask the client to control the choice, as much as possible.
R: Clients who gain confidence and feel in control of the environment is more likely to eat foods that are desired.

5. Beware if clients choose to eat low-calorie foods; hoard food; throw the food at various places such as garbage bags or baskets.
R: The client will try to avoid eating high-calorie foods that are considered and may avoid eating for a long time.

Collaboration
6. Consult with dietitian / nutritional therapy team
R: Useful in determining the needs of individual meals and resources accordingly.

7. Avoid using laxatives
R: The use of laxatives to be counter productive because laxatives are used by clients to dispose of food / calories.

8. Give a substitute for diet and snack foods that are preferred if available
R: Presenting a variety of foods allows the client to have a potentially preferred food choices.

9. Refer for dental care
R: Periodontal Disease and the exhaustion of the tooth enamel causing tooth caries and loss of fillings require immediate intervention to improve nutrition and health inputs in general.

10. Prepare / assist in elektrokonvulsif therapy (ECT) when indicated. Discuss the reasons for the use and help clients to understand that this therapy is not a punishment
R: In the case of a complicated and rarely when there is severe malnutrition / life-threatening, short ECT series allows clients to start eating and access to psychotherapy