Common Related Factors - Imbalanced Nutrition: Less Than Body Requirements
- Severe fear of obesity
- Severely distorted self-concept, self-esteem, and/or body image
- Absence of physical conditions that would explain weight loss or prevent weight gain
Defining Characteristics - Imbalanced Nutrition: Less Than Body Requirements
- Body weight 15% to 29% or more below ideal weight for height
- Self-restricted calorie intake despite hunger
- Obsession with food, calories, weight, and control issues
Common Expected Outcomes - Imbalanced Nutrition: Less Than Body Requirements
- Patient stops losing weight.
- Patient begins to gain weight.
- Patient recognizes eating disorder.
Ongoing Assessment - Imbalanced Nutrition: Less Than Body Requirements
- Record the patient’s weight and height on intake. Weigh regularly, maintaining standard conditions (i.e., same scale, same time of day, patient wearing similar clothes). This ensures accurate record of weight changes.
- Weigh the patient in a matter-of-fact manner without discussion. This reduces risk of acting-out behaviors. Weight gain is only one aspect of the total therapeutic program; other critical factors include nutritional adequacy, behaviors related to eating, appropriate use of exercise, and development of a healthy body image.
- Obtain weight history, including initial motivation for weight loss or food restrictions. Clinical anorexia can follow ordinary weight loss dieting.
- Conduct a nutritional assessment:
- Assess the patient’s beliefs and fears about food and weight gain
- Knowledge about nutrition and sources of information
- Behaviors used to reduce calorie intake (dieting), to increase energy output (exercising), and generally to lose weight (vomiting, purging, and laxative abuse)
- Assess cardiovascular, metabolic, renal, gastric, hematological, and endocrine system functioning. Assessment provides data on the severity of malnutrition.
- Monitor intake (i.e., daily food plans that track eating trends along with emotional states and triggering events). Record intake and output for the hospitalized patient. These data help determine the patient’s actual caloric intake and eating behaviors.
- Conduct a nutritional assessment:
Interventions - Imbalanced Nutrition: Less Than Body Requirements
- Prescribe appropriate nutrition and total calories per day to relieve acute starvation. A gradual refeeding prescription ensures steady weight gain and reduces risk of medical complications.
- Supervise all activities immediately before and after meals; maintain supervision consistency. This decreases opportunity to engage in compensatory activities to reduce calorie intake.
- Provide food and meals without comment. This helps separate emotional behaviors from eating behaviors.
- Set limits on all exercise but allow daily activity. Preventing all forms of exercise may induce severe anxiety.
- Assure the patient that treatment is not designed to produce obesity. Patients have an overwhelming fear of weight gain and obesity.
- Acknowledge any anger, sadness, or feeling of loss that the patient may have toward treatment. This helps provide external emotional controls that have not yet been internalized by the patient.
- Provide supplemental feedings and nutrition as indicated. Nutritional supplements may be necessary if the patient is malnourished. Tube or parenteral feedings may be necessary if the patient is unable to allow herself or himself oral feedings.
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thanks the information.excelent!!