Restrictive Type – Anorexia Nervosa (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 So we'll start with Anorexia Nervosa.

    00:03 It's characterized by an extreme fear of obesity.

    00:09 These people have gross distortion of body image.

    00:14 Despite the fact that they are thin, they see themselves when they look at their own body image as being fat.

    00:24 This perception completely takes over the way they feel about themselves.

    00:30 People with anorexia nervosa have excessive weight loss.

    00:34 They are less than 85% of the expected weight for their height.

    00:41 Now, this can be accomplished by them reducing the food intake or excessively exercising.

    00:50 Inducing vomiting themselves, they stick their fingers down their throat, or they might be over using and abusing laxatives, or diuretic medications.

    01:04 So what is going to happen? What are we going to see? We're going to see these are people who have hypothermia, their body temperature is going to be lower than average.

    01:17 They will have bradycardia.

    01:19 When they stand up, they might feel very dizzy, they'll have orthostatic hypotension.

    01:25 And for the young ladies, they will have amenorrhea or they'll have absence of their menstruation.

    01:34 We also see with anorexia nervosa, a refusal to eat.

    01:40 And that is like with the young person that I had seen, who was unable to even eat the ear of a gummy bear.

    01:48 She just refused.

    01:50 She could not tolerate the idea of eating.

    01:54 They also have a preoccupation with food, which is counter intuitive, I suppose if you're thinking they don't want to eat.

    02:02 But food becomes their enemy.

    02:05 And so they're hypervigilant to all foods because that is their enemy.

    02:13 So a person who has anorexia nervosa can develop bradycardia (very slow heartbeat), hypotension.

    02:22 And also, if they are using those medication to cause diarrhea or vomiting, they might actually induce heart failure.

    02:33 Unfortunately, a person with anorexia nervosa can starve themselves.

    02:39 And that leads them into heart failure.

    02:42 It can also lead them to brain damage.

    02:45 Our brains require glucose in order to be able to function.

    02:50 If we are not taking in any calories, our brain is not able to function.

    02:56 Hair and nails. They grow brittle.

    02:59 There may even be hair loss.

    03:03 Will find that they have anemia on a blood test.

    03:06 Their joints will start to swell.

    03:10 They won't have muscle mass, because they're not taking in the protein they need to sustain muscles.

    03:17 And they will have loss of calcium, they'll have bone loss, and that results in easily breaking a bone.

    03:27 Especially the potassium from all of the diuretics and with the vomiting.

    03:33 Just think about it, if you have a patient who is on medications for hypertension, maybe hydrochlorothiazide.

    03:43 And what do we say to them? We say,"Well, you're on a diuretic.

    03:47 You're on Lasix, for example.

    03:49 I would like you to please remember, I'd like to eat a banana in the day." And why do we say that? Because we are going to replenish the potassium that is lost because of the diuretic.

    04:02 Now, these are people who are taking diuretics, not because they have hypertension, not for any reason to make their body healthier.

    04:12 They're taking diuretics to take away the water in their body to reduce the amount of weight that they have.

    04:19 They're not thinking about the fact that with that diuretic they're also losing enormous amount of potassium, which helps our heart to be able to function correctly.

    About the Lecture

    The lecture Restrictive Type – Anorexia Nervosa (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Eating Disorders (Nursing).

    Included Quiz Questions

    1. They intentionally reduce food intake
    2. They may misuse diuretics
    3. They have a disturbance of body image
    4. They regularly misuse vitamins
    5. They weigh between 30-50% of their expected weight for their height
    1. Hypothermia
    2. Bradycardia
    3. Amenorrhea
    4. Orthostatic hypotension
    5. Hypertension

    Author of lecture Restrictive Type – Anorexia Nervosa (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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