7 Eating Disorders: Anorexia & Bulimia Nervosa Nursing Care Plans

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Anorexia nervosa is an illness of starvation, brought on by severe disturbance of body image and a morbid fear of obesity.  People with anorexia nervosa attempt to maintain a weight that’s far below normal for their age and height. To prevent weight gain or to continue losing weight, people with anorexia nervosa may starve themselves or exercise excessively.

Bulimia nervosa is an eating disorder (binge-purge syndrome) characterized by extreme overeating followed by self-induced vomiting, trying to get rid of the extra calories in an unhealthy way. It may include abuse of laxatives and diuretics.

Although these disorders primarily affect women, approximately 5%–10% of those afflicted are men, and both disorders can be present in the same individual.

Nursing Care Plans

Nursing care planning for patients with eating disorders: anorexia nervosa, bulimia nervosa includes establishing adequate nutritional intake, correcting fluid and electrolyte imbalance, assist patient to develop a realistic body image and improving self-esteem. Other than the mentioned above, it is also an important nursing priority to provide support in the treatment program and coordinate program with order disciplines.

Included in this post are seven (7) nursing care plans and nursing diagnosis for patients with eating disorders: anorexia nervosa and bulimia nervosa:

  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Risk for Deficient Fluid Volume
  3. Disturbed Thought Process
  4. Disturbed Body Image, Chronic Low Self-Esteem
  5. Impaired Parenting
  6. Risk for Impaired Skin Integrity
  7. Deficient Knowledge
  8. Other Possible Nursing Diagnoses
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Risk for Deficient Fluid Volume

Nursing Diagnosis

May be related to

  • Inadequate intake of food and liquids
  • Consistent self-induced vomiting
  • Chronic/excessive laxative/diuretic use

Possibly evidenced by (actual)

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  • Dry skin and mucous membranes, decreased skin turgor
  • Increased pulse rate, body temperature, decreased BP
  • Output greater than input (diuretic use); concentrated urine/decreased urine output (dehydration)
  • Weakness
  • Change in mental state
  • Hemoconcentration, altered electrolyte balance

Desired Outcomes

  • Client will maintain/demonstrate improved fluid balance, as evidenced by adequate urine output, stable vital signs, moist mucous membranes, good skin turgor.
  • Client will verbalize understanding of causative factors and behaviors necessary to correct the fluid deficit.
Nursing Interventions Rationale
Monitor and record vital signs, capillary refill, status of mucous membranes, skin turgor. Indicators of the adequacy of circulating volume. Orthostatic hypotension may occur with the risk of falls and injury following sudden changes in position.
Note amount and types of fluid intake. Measure urine output accurately. Patient may abstain from all intake, with resulting dehydration; or substitute fluids for caloric intake, disturbing electrolyte balance.
Discuss strategies to stop vomiting and laxative and diuretic use. Helping patients deal with the feelings that lead to vomiting and laxative or diuretic use will prevent continued fluid loss. Note: Patient with bulimia has learned that vomiting provides a release of anxiety.
Identify actions necessary to regain or maintain optimal fluid balance (specific fluid intake schedule). Involving the patient in the planning to correct fluid imbalances improves chances for success.
Review electrolyte and renal function test results. Fluid, electrolyte shifts, decreased renal function can adversely affect a patient’s recovery or prognosis and may require additional intervention.
Administer and monitor IV, TPN; electrolyte supplements, as indicated. Used as an emergency measure to correct fluid and electrolyte imbalance and prevent cardiac dysrhythmias.
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See Also

You may also like the following posts and care plans:

Endocrine and Metabolic Care Plans

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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