Eating disorder not otherwise specified
Weight, muscle, and fat congruence with height, frame, age, and sex
Calorie intake within required parameters of treatment plan
Weight at established normal range for the patient
Patient satisfaction with body appearance
“Do you often feel fat?”
“Who plans the family meals?”
“What do you eat in a typical day?”
“What do you think about your present weight?
I’m fat and ugly.”
“What I think about myself is my business.”
“I’m grossly underweight, but I cover it well.”
“I’m a few pounds overweight, but I can live with it.”
Adult failure to thrive related to abuse of laxatives, as evidenced by electrolyte imbalances and
Ineffective health maintenance related to self-induced vomiting, as evidenced by swollen parotid glands and hyperkalemia
Disturbed energy field related to physical exertion in excess of energy produced through caloric intake, as evidenced by weight loss and hyperkalemia
Imbalanced nutrition: less than body requirements related to refusal to eat, as evidenced by loss of 25% of body weight and hypokalemia
Gain 1 to 2 pounds.
Exercise 1 hour daily.
Take a laxative every 3 days.
Weigh self accurately using balanced scales.
Communicate empathy for the patient’s feelings.
Observe for adverse effects associated with refeeding.
Teach patient about psychological origins of the disorder.
Direct the patient to balance energy expenditure and caloric intake.
Severe anxiety concerning eating is expected, so objective and subjective data must be routinely collected.
Patient involvement in decision making increases sense of control and promotes adherence.
Because of risks of physical problems from refeeding, the patient’s consent is essential.
A team approach to treatment planning ensures that physical and emotional needs are met.
Pupillary reaction to light
Reports of serum electrolytes
Complaints of sleep disturbances
“What are your feelings about not eating foods you prepare?”
“You seem to feel much better about yourself when you eat something.”
“It must be difficult to talk about private matters to someone you just met.”
“Being thin doesn’t seem to solve problems. You’re thin now but still unhappy
Makes nonjudgmental comments.
Refers the patient to a self-help group for persons with eating disorders.
Teaches the patient about signs of increased anxiety and ways to intervene.
Determines the patient has poor eating habits and provides a diet to follow.
Appropriately express angry feelings.
Verbalize two positive things about self.
Verbalize the importance of eating a balanced diet.
Identify two alternative methods of coping with loneliness and isolation.
Assist the patient to identify triggers to binge eating.
Provide remedial consequences for weight loss.
Assess for signs of impulsive eating.
Explore needs for health teaching.
150 to 102 pounds over a 4-month period. Vital signs: temperature, 96.1° F; pulse, 38 beats/min; blood pressure 64/42 mm Hg.
120 to 90 pounds over a 3-month period. Vital signs: temperature, 97.2° F; pulse, 50 beats/min; blood pressure 70/50 mm Hg.
110 to 70 pounds over a 4-month period. Vital signs: temperature 97.6° F; pulse, 60 beats/min; blood pressure 80/66 mm Hg.
90 to 78 pounds over a 5-month period. Vital signs: temperature, 98.6° F; pulse, 62 beats/min; blood pressure 74/48 mm Hg. 90 to 78 pounds over a 5-month period. Vital signs: temperature, 98.6° F; pulse, 62 beats/min; blood pressure 74/48 mm Hg. 90 to 78 pounds over a 5-month period. Vital signs: temperature, 98.6° F; pulse, 62 beats/min; blood pressure 74/48 mm Hg.
Teach stress-reduction techniques such as relaxation and imagery.
Encourage the patient to design and implement an exercise program.
Explore ways in which the patient may feel more in control of the environment.
Encourage the patient to attend a support group such as Overeaters Anonymous.
Anxiety related to fear of weight gain
Disturbed body image related to weight loss
Ineffective coping related to lack of conflict resolution skills
Imbalanced nutrition: less than body requirements related to self-starvation
Provide a forum for journaling about foods eaten.
Shift the patients’ focus from food to psychotherapy.
Promote processing of anxiety associated with eating.
Focus on weight control mechanisms and food preparation.
Prominent parotid glands
Thin, brittle hair
Open displays of emotion
Weight 15% below ideal weight
Urine output less than 30 mL/hr
Serum potassium 3.4 mEq/L
Pulse rate 54 beats/min
Im fat and ugly
I have nice eyes
Im thin for my height
My mom hates me
Disturbed body image
Imbalanced nutrition: less than body requirements
Stable coalitions between family members
Interpreting negative messages as positive
Competition between the patient and father
Lack of trust in the patient by family members