Virtual Clinical Excursion: Lesson 8

Reading Assignment: Feeding, Eating, and Elimination Disorders (Chapter 18)

Patient: Tiffany Sheldon, Pediatrics Floor, Room 305
Goal: To provide nursing care for a patient with an eating disorder who also has
comorbid psychiatric symptoms.
Objectives:
Discuss the prevalence of eating disorders.
Identify common symptoms of eating disorders.
Identify the predisposing factors related to eating disorders.
List psychological problems and serious medical complications associated with eating
disorders.
Apply the nursing process in caring for a patient with an eating disorder.
Assess interactions between the nurse and a patient with an eating disorder.
Develop a treatment plan for a patient with an eating disorder.
List outcomes for a patient with an eating disorder.

Exercise 1

Writing

1. Individuals with ANOREXIA NERVOSA refuse to maintain a minimally normal

weight for height and express intense fear of gaining weight.

2. The prevalence of eating disorders is on the increase in our culture. In addition,

comorbid psychiatric illnesses are high in patients with eating disorders. Place an X
next to each true statement regarding eating disorder statistics.

<INPUT TABINDEX=\- Eating disorders are more common among men than
among women.
<INPUT TABINDEX=\X Most eating disorders begin in the early teens to
mid-20s.
-Incidence of obsessive-compulsive personality disorder accounts for 25% of
those with anorexia nervosa restricting type.
<INPUT TABINDEX=\-The major cause of death in patients diagnosed with
eating disorders is suicide.
<INPUT TABINDEX=\X Depression and anxiety are common comorbid
conditions in people who binge eat.
-A history of childhood trauma and sexual abuse is less common in those with
eating disorders than in the general population.
<INPUT TABINDEX=\X Fewer than 50% of people with eating disorders
seek medical care.

3. Place an X next to the statements that best reflect the most common symptoms of
eating disorders.
 <INPUT TABINDEX=\ Intense fear of gaining weight
<INPUT TABINDEX=\ X Skipping meals occasionally
<INPUT TABINDEX=\X Depriving self of needed nourishment
<INPUT TABINDEX=\X Severe dieting
<INPUT TABINDEX=\ X Overeating under stress
<INPUT TABINDEX=\ XChewing food very slowly
<INPUT TABINDEX=\ XFrequent fasting
<INPUT TABINDEX=\X Binge eating behaviors
<INPUT TABINDEX=\X Thinking of oneself as fat even though underweight
<INPUT TABINDEX=\ XSelf-induced vomiting

4. Disordered eating can lead to serious medical complications and psychological

problems. List some of the medical complications and psychological problems.

Medical Complications:
Orthostatic changes in pulse or bp , cardiac arrhythmias, leukopenia, abnormal
thyroid functioning, peripheral neuropathy

Psychological Problems:
Terror of gaining weight, preoccupation with thoughts of food, view of self as fat
even when emaciated, possible development of rigorous exercise regimen

5. There are many factors that predispose a person to develop an eating disorder.
Place an X next to the predisposing factors associated with eating disorders.

<INPUT TABINDEX=\ X Rigid, meticulous, ritualistic, obsessive-compulsive

behaviors
<INPUT TABINDEX=\ No early childhood issues and a healthy family life
<INPUT TABINDEX=\X Pervasive sense of ineffectiveness and helplessness;
no control over life
<INPUT TABINDEX=\ Understanding others' feelings and being able to
handle one's own intense emotions
X Cognitive distortions
<INPUT TABINDEX=\X History of sexual abuse

6. How do you think social norms regarding body size affect the prevalence of eating
disorders in women in the United States?

- Western cultural ideal that equates feminine beauty to tall, thin models has received
much attention in the media as an etiology for the eating disorders. Its known that
peer behaviors and attitudes may contribute to the body dissatisfaction that all eating
disordered patients feel.
 7. Many people who are in treatment for eating disorders have evidence of other
psychiatric disorders. Complete the psychiatric comorbidity for each eating disorder
listed in the table below.

Eating Disorder: Psychiatric Comorbidity:

Anorexia nervosa ---- distorted body image, intense fear of weight gain
Bulimia nervosa ---inappropriate compensatory behavior, self image largely
influenced by body image
Binge eating disorder--- binging episodes induce guilt, depression, embarrassment or
disgust

8. Discuss the environmental factors that may predispose someone to an eating disorder.

- in industrialized cultures where there is an emphasis on thinness, especially if thinness

is linked to success. Magazines, television, and other media have created an unrealistic
image of the perfect, successful person. The pressure to be thin can lead to intense
dieting, even in very young children, which can turn into an eating disorder in people
who are more likely (predisposed) to get the disorders.

9. What sociocultural biases do you have regarding those who have eating disorders that
result in them being severely underweight or overweight?

- Our media’s increased obsession with the thin-ideal and industry promotion of a
“perfect” body may contribute to unrealistic body ideals in people with and without
eating disorders.