ANOREXIA NERVOSA

Question 1

2 subtypes of anorexia nervosa

Answer 1

RESTRICTING TYPE
BINGE-EATING/PURGING TYPE

Question 2

Restriction of energy intake leading to significantly low body weight

Answer 2

ANOREXIA NERVOSA

Question 3

Intense fear of becoming fat or gaining weight even when underweight. Distorted perception of body weight or shape.

Answer 3

ANOREXIA NERVOSA

Question 4

Weight loss thru dieting or fasting or excessive exercise

Answer 4

RESTRICTING TYPE

Question 5

Episodes of bingeing or purging(vomiting, laxatives, etc.)

Answer 5

BINGE EATING/ PURGING TYPE

Question 6

What are the risk factors of anorexia nervosa?

Answer 6

Genetic disposition
Neurochemical imbalances
Perfectionism
Low self esteem
Obsessive compulsive traits
Anxiety or depressive disorders
Cultural pressure
Media portrayal
Peer pressure
Bullying
Dysfunctional family dynamics
History of trauma or abuse

Question 7

What are the clinical manifestations of anorexia nervosa?

Answer 7

Extreme weight loss(less than 17.5 BMI)
Amenorrhea
Bradycardia
Hypotension
Lanugo
Dry skin
Brittle nails
Constipation and dehydration
Electrolyte imbalance
Social withdrawal
Poor concentration
Intense fear of weight gain
Denial of hunger
Distorted body image

Question 8

What are the nursing interventions for anorexia nervosa?

Answer 8

ESTABLISH TRUST
-use non judgemental, empathetic approach
-build a therapeutic nurse to client relationship
NUTRITIONAL SUPPORT
-Encourage gradual weight restoration thru structured meal planning
-Monitor meal consumption and prevent post meal puring behavior
BEHAVIORAL MANAGEMENT
-Limit excessive exercise and provide supervised activity
-Contracting for meal completion and behavior monitoring

Question 9

NI FOR ANOREXIA NERVOSA

Answer 9

PSYCHOLOGICAL SUPPORT
-provide emotional support for body image and self esteem
-use of cognitive behavioral strategies to challenge distorted beliefs.
EDUCATION
-teach about risk factors and dangers of malnutrition and importance of balanced diet
-health education about disease, management and safety
SAFETY MONITORING
-monitor for signs of suicidal ideation and self harm
-check for physical complications(ECG, electrolyte monitoring)

Question 10

NURSING PRIORITIES FOR ANOREXIA NERVOSA

Answer 10

MEDICAL STABILIZATION
-correct electrolyte imbalance and manage dehydration
-monitor for refeeding syndrome(shift of fluids and electrolytes during replacement)
RESTORE NUTRITIONAL HEALTH
-monitor weight daily
-implement a structured meal plan
SAFETY OR PREVENTION OF HARM
-close observation after meals to prevent purging
-monitor vs and lab results
PSYCHOLOGICAL CARE
-address distorted thinking patterns
-support patient’s autonomy while guiding towards recovery

Question 11

Medical management(multidisciplinary approach) for anorexia nervosa

Answer 11

PSYCHIATRIC NURSE
PSYCHOLOGIST/PSYCHIATRIST
NUTRITIONIST
PHYSICIANS

Question 12

Hospitalization criteria for anorexia nervosa

Answer 12

a.Rapid or severe weight loss
b.BMI of less than 15
c.Severe bradycardia,hypotension,
hypothermia
d.Electrolyte imbalance
e.Risk for suicide or self-harm
f.Failure of out-patient treatment

Question 13

THERAPEUTIC MODALITIES for anorexia nervosa

Answer 13

·Cognitive Behavioral Therapy (CBT):To challenge distorted
beliefs about weight and food.
·Family-Based Therapy (FBT):Especially effective in adolescents.
·Dialectical Behavior Therapy (DBT):If comorbid emotional
dysregulation exists.
·Nutritional Rehabilitation:Gradual refeeding under medical
supervision.

Question 14

PHARMACOLOGIC MANAGEMENT FOR ANOREXIA NERVOSA

Answer 14

●Olanzapine (atypical
antipsychotic)-Promotes weight gain,reduces obsessive thinking(Metabolic side effects)
●Fluaxetine(SSRI)-Depression,anxiety,relapse,
prevention(Use after partial weight restoration)
●Multivitamins and Supplements-Replace deficiencies (iron,
calcium,vitamin D,B12) (Monitor lab levels)
●Electrolyte replacements-Correct hypokalemia,hypophosphatemia(Monitor with frequent labs)