the role of a nurse in assessing for eating disorders patients

Eating disorders affect roughly 3% of the population and the majority are women (Muscari, 2015). Eating disorders are serious conditions that negatively affect the person’s health and emotion. The exact cause of eating disorders is unknown. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can significantly impact the body in receiving a well-balanced nutrition. Most eating disorders affect on body weight and leading to dangerous eating behaviors. In addition, eating disorders can harm the digestive system and can lead to complications. Eating disorders often happen among teen and young adult, but they can develop at other age groups as well (Muscari, 2015). Eating disorders is a dangerous eating behaviors that need to receive treatment, but only a small percent of the sufferers seek treatment. With proper care and treatment, the person can return to normal, healthy eating habit. As a healthcare professional, nurses have an important role in identifying, assessing, caring and treating eating disorders effectively.

It is important that all nurses are knowledgeable about eating disorders and appropriately understand how to assess, identify and provide care for patients with eating disorders. Many patients are having eating disorders are often not recognised. Nurses need to ensure that they can access eating disorders and provide necessary interventions. The prioprity assessment for eating disorder is to assess patient’s nutritional status. As eating disorders can be life threatening, the most important is to ensure that the patients maintain electrolyte balance and adequate nutrition requirement for the body. The nurse’s role is to take detailed dietary intake. As eating disorders are largely affect young women, a nurse should also take detail history of menstrual function of the patient. If an eating disorder has been identified, the nurse must monitor the weight of the patients on a regular basis. In addition, the nurse should assess patient’s skin condition for breakdown and skin’s poor healing (Muscari, 2015). Protein is necessary in aiding body tissue repairment. A lack of protein intake can result in skin more likely to break down. Moreover, the nurse needs to assess the oral hygiene and dental related problems. It is vital to keep a good oral hygiene due to recurrent vomiting which can cause significant damage to the tooth enamel (Sharp, 2017). It is also essential to assess for waste elimination pattern. It is common in eating disorder patients as they excessively use of diuretics and laxatives. The misuse of diuretics and laxatives, many patients may require intervention to treat constipation. Finally, it is important to assess patient’s activity levels. Patients who is present with anorexia may undertake excessive exercise that can be detrimental to their physiological state. Excessive exercise can delay or slow their recovery if they have physical illness(Muscari, 2015).

Anorexia Nervosa

In anorexia nervosa, patients have an intense fear of weight gain and distorted body image. They have a disturbed perception of their own body image. As a result, these patients restrict on calories and end up with low body mass index. They suffer significant weight loss and refuse to maintain normal body weight. The age of onset is usually from pre-puberty to middle age. The condition primarily affects young women, but the disorder seems to increase nowadays in younger males. In some people, anorexia may occur as an acute in the beginning, then it progresses to chronic condition after many years suffering from the disorder. Signs and symptoms of anorexia nervosa: weight loss, refusal of eating, loss of appetite, fear of being obese, self-induced vomiting, difficulty in swallowing, use or abuse of laxatives, constipation (Muscari, 2015). The nurse should be aware of the signs and symptoms as well as the related physical problems that can become life threatening. Many of the physical problems are: electrolyte imbalance, bradycardia, hypotension, hypothermia, fatigue (Muscari, 2015).

Bulimia Nervosa

In bulimia nervosa, patients is having recurrent pattern of uncontrollable binging. They consume large amounts of food by binge eating, which is followed by vomiting or heavy laxative use known as purging behaviour. In these patients, self-image largely influenced by odly image. Most cases of bulimia nervosa occurs primarily in women during adolescence and early adulthood. The individuals who are affected by bulimia nervosa remains within their normal weight range, but their lives are controlled by this conflict with food. Nurses should be able to identify signs and symptoms as well as their behavior in order to help patients to obtain necessary support and treatment. The signs and symptoms to recognise bulimia nervosa are: inadequate nutritional intake, overuse of laxatives and diuretics, preoccupation with food, diet and weight, induced vomiting after eating, solitary eating or eating in secret, fatigue, distorted body image, excessive exercise, anxiety, perfectionism, poor interpersonal relationships

Binge Eating

Patients who is present with binge eating have recurrent pattern of uncontrollable binging without compensatory behaviors. The binging patterns induce guilt, depression, embarrassment, or disgust. Patients who have binge-eating disorder regularly eat too much food and having trouble to control over eating. In these patients, they may eat quickly or they eat more food than intended even when they are not hungry. After a full eating, they may feel guilty, disgusted or ashamed by the amount of food they consumed or their behavior of over eating. As the result of feeling embarrassment, they end up eating alone to hide their over eating behavior (Muscari, 2015).

Subjective Eating Disorders

The people who are present with eating disorders denying of eating extreme amounts of food. They admit that they are eating relatively small or moderate amounts of food throughout the day. They are misperceiving on the amount of food they consume (Muscari, 2015).

Objective Eating Disorders

They can consume as much as 5,000 to 15,000 calories in a single episode. This is an excessive amount of food intake which exceeds the calorie recommendations for both men and women for an entire day (Muscari, 2015).

Family Education

It is very important for the nurse to educate, family, relative, or who is taking care of the patients, about eating disorder that is related to patient’s symptoms. Family members are very important in providing support and care for the patient. In addition, it is necessary to observe for potential suicide risk of the patient.The nurse wants to ensure that the patients take responsibility for an effective outcome of the treatment by establishing a contract to limit on the amount and type of food to be eaten at each meal.

Cultural Competence

Nurses will have difficulty in learning that minority cultures have differences in their perception for being thin. For example, Asian American individual will not report of having eating disorder as they don’t have the desire to be thin. Nurses in the field of treating eating disorder have to learn that other cultures are different in their eating disorder expression becausthey do not fit with the Westernized ideal of thinness (Muscari, 2015) .

Ethical issue

Patients admit for treatment are under control such as monitoring meals, movement, exercise restriction, bathroom observation, and enforced feeding. These clinical measures can contribute to the loss of autonomy and control of the patients (Sharp, 2017). They feel like they loss the freedom and the choice to make their own decision. When the patients sense that they loss of freedom and choice, they may rebel and result in a lack of compliance. Futhermore, it can also feel like punishment. When patient cooperates in the operation, the outcome is having higher chance to achieve (Muscari, 2015).

Visit Eating Recovery Center

The Eating Recovery Center located in Denver. It offers treatment program related to eating disorder. I asked if someone who is suffering from eating disorders be able to recover after treatment. They said that the person who arrives at their facility and follow up with proper treatment, full and lasting recovery is possible. They also encourage to introduce the facility to those who are suffering from the disorders. They explained that binge eating disorder does not mean somebody lacks self-control. It is an illness that requires specialized therapeutic care. It should not be a shame in having binge eating disorder and there is no shame in seeking professional help. When I work on the paper, I thought binge is uncontrolled eating disorder.

Reference

  1. Muscari, M. E. (2015). The Role of the Nurse Practitioner in the Diagnosis and Management of Bulimia Nervosa: Psychosocial Management. Journal of the American Academy of Nurse Practitioners, 5(6), 259-263.
  2. Sharp, Freeman (2017). The medical complications of anorexia nervosa. Br J Psychiatry , 21(2), 452-462.

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