Nursing Management of Eating Disorders Lecture Outline for Dosette Bush Jones, MSN, RN-BC, CNS I. Mental Health of Adolescence Characteristics o Transition from childhood to adulthood Age 15-19 psychological struggle physiologic struggle *Successful achievement of earlier developmental tasks influence transition *Level and control of anxiety- excessive anxiety can promote a variety of disorders II. Developmental tasks adapting to a maturing body o physical, physiological, emotional emancipation from parental ties o conflict acts as vehicle for separation establish identity o defining self III. Disorders of adolescence Anorexia Bulimia Substance abuse Antisocial behavior Identity disorders Adjustment disorders Depression/suicide IV. Assessment age expected behavior -within normal expectations duration of behavior -transient or prolonged lethality of behavior -how lethal is the adolescent’s behavior scope of the problem -“who’s problem is it really?”
V. Nurse-adolescent relationships need to mature -reduce counter transference -include in decision making; explain procedures -answer questions express opinion -establishes “one-self” as an individual -do not impose your personal standards -accept what the patient has to say consider family involvement -consider family involvement -quality of parent-child relationship treat with dignity and respect -regard their concerns and issues seriously set fair limits VI. Anorexia Nervosa Definition : Self-imposed starvation; nervous loss of appetite -Maladaptive response to manage stress/anxiety through the avenue of one’s body and food - can occur on continuum- anorexic like full blown anorexia - refuses to maintain healthy body weight Incidence: Incidence found more often in white, middle class female with above average scholastic achievement (about 1% of girls, less than 10% are male), desire for perfection, unrealistic fear of failure, usually age 16-20, Etiology of anorexia nervosa Biologic model o Dysfunctional hypothalamus o Decreased amount of norepinephrine and serotonin Psychodynamic model o Inability to separate from family o Over-dominant mother o Over protected o Issue of self-control Refuses to maintain normal weight Family model o Over-fusion of members, no individuality Sociocultural model o Religious underpinning for gluttony o U.S. being thin is valued; higher potential for reward Thin is in o Can be a learned behavior D/T peer pressure Multidimensional model o A blend of all etiologies
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- Fall '19
- Bulimia nervosa