Nursing Care Plans for Bulimia Nervosa

Bulimia nervosa the binge and purge syndrome is an eating disorder, the essential features of bulimia nervosa include eating binges followed by feelings of guilt, humiliation, and self deprecation guilt, and anxiety over fear of weight gain. Characterized by extreme overeating, followed by self induced vomiting and abuse of laxatives, diuretics, strict dieting or fasting to overcome the effects of the binges. Unless the patient devotes an excessive amount of time to binging and purging, bulimia nervosa seldom is incapacitating.

Bulimia nervosa usually begins in adolescence or early adulthood and can occur simultaneously with anorexia nervosa. The disorder occurs predominantly in females and begins in adolescence or early adult life. Between 1% and 3% of adolescent and young females meet the diagnostic criteria for bulimia nervosa; 5% to 15% have some symptoms of the disorder.

Causes for Bulimia Nervosa

The exact cause of bulimia is unknown, but bulimia is generally attributed to a combination of psychological, genetic, and physiological causes. Such factors include family disturbance or conflict, sexual abuse, maladaptive learned behavior, struggle for control or self-identity, cultural overemphasis on physical appearance, and parental obesity. Bulimia nervosa is strongly associated with depression. Predisposing Factors to Anorexia Nervosa and Bulimia Nervosa

Complications for Bulimia Nervosa

Dental caries result from repetitive vomiting in bulimia nervosa.
Erosion of tooth enamel.
Parotitis
Gum infections.
Arrhythmias and even sudden death result from electrolyte imbalances.
Ipecac syrup intoxication can cause cardiac failure in patients who rely on this drug to induce vomiting.
Esophageal tears and gastric ruptures rare complications.
Mucosal damage can occur if patient with bulimia nervosa use laxatives and enemas.
Potential psychiatric complication of bulimia nervosa is suicide.
Bulimia nervosa patients are more prone to psychoactive substance use disorders.

Nursing Assessment Nursing Care Plans for Bulimia Nervosa

Patient history of bulimia nervosa is characterized by episodic binge eating several times per day. Commonly reports a binge eating episode during which she continues eating until abdominal pain. The Bulimia Nervosa patient usually preferred food that sweet, soft, and high in calories and carbohydrate. Unlike the anorexic nervosa patient bulimic patient usually can keep her eating disorder hidden, because patient's weight frequently fluctuates, but usually stays within the normal range through the use of diuretics, laxatives, vomiting, and exercise. The patient may complain of abdominal and epigastric, Amenorrhea, Painless swelling of the salivary glands, hoarseness, throat irritation or lacerations, and dental erosion. A Bulimia Nervosa patient commonly is perceived by others as a perfect person’s, However, the patient's psychosocial history may reveal an exaggerated sense of guilt, symptoms of depression, childhood trauma (especially sexual abuse), parental obesity, or a history of unsatisfactory sexual relationships.

Symptomatology for Bulimia Nervosa

Patients with Bulimia Nervosa usually solitary and secret and patients with Bulimia Nervosa able to consume thousands of calories in one binge episode.
Loss of control to stop eating After the binge has begun
After binge eats, the individual engages in inappropriate compensatory measures to avoid gaining weight, like self-induced vomiting, excessive use of laxatives, diuretics, or enemas, and extreme exercising.
Eating binges may be viewed as pleasurable but are followed by intense self criticism and depressed mood.
Patient with Bulimia Nervosa usually within normal weight range, some a few pounds underweight, and some a few pounds overweight.
Obsession with body image and appearance is a predominant feature of this disorder.
Binges usually alternate with periods of normal eating and fasting.
Excessive vomiting may lead to problems with dehydration and electrolyte imbalance.
Gastric acid in the vomitus may contribute to the erosion of tooth enamel.

Treatment for Bulimia Nervosa
Treatment of bulimia nervosa may continue for several years. Interrelated physical and psychological symptoms must be treated simultaneously.

Nursing diagnosis Nursing Care Plans for Bulimia Nervosa