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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Deficient Knowledge

Nursing Diagnosis

May be related to

  • Lack of exposure to/unfamiliarity with information about the condition
  • Learned maladaptive coping skills

Possibly evidenced by

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  • Verbalization of misconception of the relationship of current situation and behaviors
  • Preoccupation with extreme fear of obesity and distortion of own body image
  • Refusal to eat; binging and purging; abuse of laxatives and diuretics; excessive exercising
  • Verbalization of need for new information
  • Expressions of desire to learn more adaptive ways of coping with stressors

Desired Outcomes

  • Client will verbalize awareness of and plan for lifestyle changes to maintain a normal weight.
  • Client will identify the relationship of signs/symptoms (weight loss, tooth decay) to behaviors of not eating/binging-purging.
  • Client will assume responsibility for own learning.
  • Client will seek outsources/resources to assist with making identified changes.
Nursing Interventions Rationale
Determine the level of knowledge and readiness to learn. Learning is easier when it begins where the learner is.
Note blocks to learning (physical, intellectual, emotional). Malnutrition, family problems, drug abuse, affective disorders, and obsessive-compulsive symptoms can be blocks to learning requiring resolution before effective learning can occur.
Provide written information for the patient and SO(s). Helpful as a reminder of and reinforcement for learning.
Discuss the consequences of behavior. Sudden death can occur because of electrolyte imbalances; suppression of the immune system and liver damage may result from protein deficiency, or gastric rupture may follow binge-eating and vomiting.
Review dietary needs, answering questions as indicated. Encourage the inclusion of high-fiber foods and adequate fluid intake. Patient and family may need assistance with planning for a new way of eating. Constipation may occur when laxative use is curtailed.
Encourage the use of relaxation and other stress-management techniques (visualization, guided imagery, biofeedback). New ways of coping with feelings of anxiety and fear help patient manage these feelings in more effective ways, assisting in giving up maladaptive behaviors of not eating and binging-purging.
Assist with establishing a sensible exercise program. Caution regarding overexercise. Exercise can assist with developing a positive body image and combats depression (release of endorphins in the brain enhances a sense of well-being). However, the patient may use excessive exercise as a way to control weight.
Discuss the need for information about sex and sexuality. Because avoidance of own sexuality is an issue for this patient, realistic information can be helpful in beginning to deal with self as a sexual being.
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See Also

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