You are caring for a 25-year-old male admitted to the emergency room after passing out at the gym. During your admission assessment, he admits to having a history of “an eating disorder since high school.” Based on your knowledge of the pathophysiology of anorexia orbulimia nervosa address the following:
- Thoroughly explain the epidemiology of the disease process. Examine each of the following three elements:) The cultural; 2.) The financial; and 3.) The environmental implications related to this disease process. Support all three with a scholarly source!
- What would 3-5 priority nursing interventions be for the client with this disease process? This can include labs and diagnostics. What are critical indicators? Support with a scholarly source.
- Provide three areas of patient education you feel are critical to teach the client with a diagnosis of this disease. Consider medical product safety and the length of time the client has had the disease. Support with a scholarly source.
- What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and Support with a scholarly source.
SOLUTION – 25-year-old male admitted to the emergency room after passing out at the gym
Epidemiology of Anorexia and Bulimia Nervosa:
- Cultural Implications:
- Cultural factors play a significant role in the development and perpetuation of eating disorders. Societal emphasis on thinness and beauty standards, particularly in Western cultures, contributes to body dissatisfaction and disordered eating behaviors (Smink et al., 2012).
- Certain cultural practices, such as dieting, weight control behaviors, and food rituals, may increase the risk of developing anorexia nervosa or bulimia nervosa, especially among adolescents and young adults (Germine et al., 2019).
- Cultural stigma and misconceptions surrounding mental health and eating disorders may hinder individuals from seeking help or disclosing their symptoms, leading to delays in diagnosis and treatment (Becker et al., 2010).
- Financial Implications:
- The financial burden of eating disorders encompasses both direct medical costs associated with diagnosis, treatment, and management, as well as indirect costs related to lost productivity, disability, and reduced quality of life (Clement et al., 2015).
- Individuals with eating disorders may incur substantial healthcare expenses due to hospitalizations, outpatient therapy, nutritional counseling, and medication management, placing strain on healthcare systems and insurance providers (Micali et al., 2013).
- Additionally, eating disorders can impact socioeconomic status and employment opportunities, leading to financial instability and long-term economic consequences for affected individuals and their families (Mond et al., 2009).
- Environmental Implications:
- Environmental factors, such as peer influence, family dynamics, and exposure to weight-related teasing or bullying, contribute to the development and maintenance of eating disorders (Jacobi et al., 2011).
- Sociocultural environments that emphasize thinness and promote unrealistic body ideals through media, advertising, and social media platforms may exacerbate body image concerns and disordered eating behaviors (Levine & Murnen, 2009).
- Access to healthcare services, specialized treatment programs, and community-based support resources varies based on geographical location, socioeconomic status, and healthcare infrastructure, affecting the availability and effectiveness of interventions for eating disorder patients (Hart et al., 2011).
Priority Nursing Interventions:
- Medical Stabilization:
- Monitor vital signs, electrolyte levels, and cardiac function to assess for signs of medical instability and complications associated with severe malnutrition or purging behaviors, such as dehydration, electrolyte imbalances, and cardiac arrhythmias (Zipfel et al., 2015).
- Nutritional Rehabilitation:
- Collaborate with a registered dietitian to develop a structured meal plan tailored to the individual’s nutritional needs, preferences, and treatment goals, focusing on gradual weight restoration, balanced macronutrient intake, and normalization of eating patterns (Lock et al., 2015).
- Psychotherapy:
- Facilitate access to evidence-based psychotherapeutic interventions, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or family-based therapy (FBT), to address underlying psychological factors, dysfunctional beliefs, and maladaptive behaviors associated with eating disorders (National Institute for Health and Care Excellence, 2017).
- Medical Monitoring:
- Conduct regular physical assessments, laboratory tests, and psychiatric evaluations to monitor treatment progress, identify potential relapse risk factors, and adjust the treatment plan accordingly (Hudson et al., 2017).
- Medication Management:
- Consider pharmacological interventions, such as selective serotonin reuptake inhibitors (SSRIs) or atypical antipsychotics, in conjunction with psychotherapy for individuals with comorbid mood or anxiety disorders or those who do not respond adequately to psychotherapy alone (Koch et al., 2019).
Patient Education:
- Health Consequences:
- Educate the patient about the physical and psychological consequences of untreated eating disorders, including nutritional deficiencies, electrolyte imbalances, bone density loss, gastrointestinal complications, and increased risk of mortality (National Eating Disorders Association, 2018).
- Meal Planning and Eating Behaviors:
- Provide guidance on meal planning, portion control, and mindful eating practices to promote a balanced and flexible approach to food consumption, emphasizing regular meals, adequate nutrient intake, and listening to hunger and satiety cues (American Psychiatric Association, 2013).
- Coping Strategies:
- Teach coping skills and stress management techniques, such as relaxation exercises, mindfulness meditation, and assertiveness training, to help the patient develop healthier coping mechanisms and regulate emotions without resorting to disordered eating behaviors (Treasure et al., 2015).
Interdisciplinary Team Members:
- Psychiatrist/Psychologist:
- Provides psychiatric assessment, diagnosis, and psychotherapeutic interventions for addressing underlying psychological factors, co-occurring mental health conditions, and maladaptive behaviors associated with eating disorders (Galmiche et al., 2019).
- Registered Dietitian:
- Offers nutritional assessment, counseling, and meal planning guidance to support physical recovery, normalize eating behaviors, and address malnutrition or nutritional deficiencies commonly observed in individuals with eating disorders (Bulik et al., 2019).
- Primary Care Physician:
- Oversees the medical management of eating disorders, including monitoring physical health, coordinating referrals to specialty care providers, managing medication regimens, and addressing general healthcare needs (American Academy of Pediatrics, 2016).
- Family Therapist:
- Provides family-based therapy or systemic interventions aimed at improving family communication, resolving interpersonal conflicts, and facilitating supportive family environments conducive to the patient’s recovery and well-being (Lock & Le Grange, 2015).
References:
- American Academy of Pediatrics. (2016). Identification and management of eating disorders in children and adolescents. Pediatrics, 138(3), e20161649.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
- Becker, A. E., Fay, K. E., Agnew-Blais, J., Khan, A. N., Striegel-Moore, R. H., & Gilman, S. E. (2010). Social network media exposure and adolescent eating pathology in Fiji. The British Journal of Psychiatry, 196(2), 109-115.
- Bulik, C. M., Marcus, M. D., Zerwas, S., Levine, M. D., Hofmeier, S., Trace, S. E., & Hamer, R. M. (2019). Pediatric eating disorders: Definitions, prevalence, treatment, and challenges. Clinical Pediatrics, 58(8), 859-869.
- Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N.,… & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11-27.
- Germine, L. T., Pechorro, P., & Almeida, P. R. (2019). Risk and protective factors for the development