Anorexia Nursing Diagnosis and Nursing Care Plan

Last updated on January 27th, 2024 at 09:00 am

Anorexia Nursing Care Plans Diagnosis and Interventions

Anorexia NCLEX Review and Nursing Care Plans

Anorexia nervosa, better known as anorexia, is an eating disorder marked by low body weight, intense fear of gaining excess weight, and a misguided perspective about weight. Individuals with anorexia generally restrict their food intake to avoid gaining weight or continue losing weight.

They may limit their calorie intake by vomiting after eating or abusing laxatives, herbal or diet supplements, diuretics, or fleet enemas. They may also try to drop pounds by overexerting themselves. Thus, no matter how much weight is reduced, the individual is still afraid of gaining weight.

Furthermore, anorexia is not solely about food and nutrition. When individuals suffer from anorexia, they deal with emotional struggles in an unhealthy and fatal way to cope with it. They also frequently associate body shape with self-worth.

Moreover, like with other eating disorders, anorexia has the potential to take over someone’s life and be extremely tough to handle. However, patients can rediscover their identity with treatment, reintroduce healthier eating habits, and reverse some of anorexia’s significant complications.

Causes and Risk Factors of Anorexia

Anorexia’s actual cause is inconclusive. As with many disorders, it is most likely the combined effect of biological, psychological, and environmental variables.

  1. Biological Factors. Although it is unclear which genes are involved, chromosomal irregularities may put some people at a higher risk of developing anorexia. Some individuals may have a hereditary tendency for perfectionism, sensitivity, and persistence, all of which are related to anorexia.
  2. Psychological Factors. Some anorexics may have obsessive-compulsive qualities that make it easier to continue restrictive diets and avoid food even when hungry. They may have a strong desire for perfection, which leads them to believe they are never skinny enough. They may also experience significant anxiety and participate in restrictive eating to alleviate it.
  3. Environmental Factors. Body image is given more importance in modern Western society. Becoming slim is frequently associated with success and self-value. Peer influence, especially among young girls, may contribute to the urge to be slim.

Anorexia can strike anyone, irrespective of gender, age, or color. Certain circumstances, however, put some individuals at a higher risk of developing anorexia. Several factors of anorexia are explained below:

  • Age. Eating disorders, notably anorexia, are more prevalent in teenagers and young adults, but small children and elderly persons can acquire anorexia as well.
  • Gender. Women are more highly diagnosed with anorexia than the general population. It is crucial to note that men and boys can suffer from anorexia and may be inadequately diagnosed due to disparities in seeking medical help.
  • Family history. If patients have a parent or sibling (first-degree family) who has an eating disorder, they are more likely to acquire one.
  • Dieting. Excessive dieting can lead to anorexia.
  • Changes and trauma. Significant life changes, such as attending university, starting a career, or filing for divorce, as well as trauma, such as sexual assault or physical abuse, may precipitate the emergence of anorexia.
  • Certain occupations and sports activities. Celebrities, athletes, runners, boxers, and dancers are more vulnerable to eating disorders.

Signs and Symptoms of Anorexia

Physical manifestations of anorexia may include:

  • Excessive weight loss or failure to make planned developmental weight changes
  • Excessive slimness
  • Fainting or dizziness
  • Abnormal blood counts
  • Fatigue
  • Difficulty in sleeping
  • Delayed menstruation schedule
  • Hypotension
  • Hair that is thinning, breaking, or falling out
  • Constipation and abdominal discomfort
  • Skin that is flaky or yellowish
  • Dehydration
  • Teeth erosion and calluses on the knuckles as a result of induced vomiting
  • Cold intolerance
  • Abnormal heartbeats

Anorexia’s behavioral signs may include efforts to drop pounds by:

  • Dieting or fasting severely restricts food consumption.
  • Excessive exercise
  • Binge eating and inducing vomiting to get rid of food through laxatives, fleet enemas, diet, or herbal supplements.

Among the emotional and behavioral indications and symptoms are the following:

  • Food obsession sometimes includes preparing extravagant meals for others but not consuming them.
  • Skipping meals or refusing to eat regularly
  • Making reasons for not eating or denying hunger

Diagnosis of Anorexia

If the doctor suspects anorexia nervosa, he or she will usually do a series of tests and exams to narrow down a diagnosis, rule out possible factors for weight loss, and look for any associated issues. These exams and tests typically involve the following:

  • Physical examination. This procedure may include measuring the height and weight, monitoring the vital signs such as heart rate, blood pressure, and temperature, looking for abnormalities with the skin and nails, checking the heart and lungs, and assessing the abdomen.
  • Laboratory tests. A complete blood count (CBC) and more specialized blood tests to examine electrolytes and protein, as well as the function of your liver, kidney, and thyroid, may be performed. A urinalysis may also be performed.
  • Psychological assessment. A doctor or mental health expert will almost certainly inquire about a patient’s thoughts, emotions, and eating patterns. The patient may be requested to fill out psychological self-assessment questionnaires as well.
  • Other procedures. X-rays may be done to assess bone density, look for fractured bones, or rule out pneumonia or heart problems. Electrocardiograms may be performed to detect cardiac abnormalities.

Treatment for Anorexia

  1. Psychotherapy. This treatment is a psychological therapy that focuses on modifying a person’s thinking (cognitive therapy) and conduct (behavioral therapy) to help them overcome an unhealthy relationship with food.
  2. Medication. Certain tricyclic antidepressants may be used to assist in regulating anxiety and depression caused by an eating disorder and improve sleep and promote appetite.
  3. Nutrition counseling. This strategy is intended to teach a healthy diet and lifestyle and to aid in the restoration of balanced eating patterns, and instill the value of nutrition and a well-balanced diet.
  4. Group and family therapy. Family support is critical to the effectiveness of treatment.
  1. Hospitalization. In some situations, the patient may require nourishment via a nasogastric tube or an IV.

Prevention of Anorexia

  • Create a positive self-image
  • Learn about eating disorders
  • Avoid excessive dietary restrictions
  • Do not falter to consult a health expert as soon as symptoms manifest and prevent them from getting worse.
  • Strengthen a support group that enables an individual to share their health concerns.

Anorexia Nursing Care Plans

Anorexia Nervosa Nursing Care Plan 1

Deficient Knowledge

Nursing Diagnosis: Deficient Knowledge related to lack of comprehension about the health condition secondary to anorexia nervosa as evidenced by verbalization of the desire to learn new information about the disorder.

Desired Outcome: The patient will be knowledgeable enough about the eating disorder and will be able to manage it.

Nursing Interventions for Anorexia NervosaRationale
Determine the barriers to learning, whether physical, emotional, or intellectual.  Malnourishment, family issues, drug misuse, emotional disorders, and obsessive-compulsive symptoms can all be barriers to learning that must be addressed before optimal learning occurs.  
Prepare written notes for the patient, where all important things about the disorder are found.  Written notes are an important and effective way of learning.    
Evaluate the patient’s diet. On the other hand, make sure that the patient is not abusing laxatives. Instead, include high fiber and sufficient fluids in his or her diet.    This method will ensure that the patient is not restricting his diet too much. Thus, constipation will be avoided if laxatives are not utilized improperly.
Facilitate the implementation of a sensible fitness program for the patient. Over-exercise should be avoided.    Exercise can help build a healthy body image and alleviate anxiety as it releases endorphins in the brain and enhances a sense of well-being. Hence, too much exercise can be the patient’s excuse to reduce too much weight.  
Advocate the use of meditation and stress-reduction practices such as biofeedback, guided imagery, and visualization.    New techniques of dealing with tension and stress help patients manage these sensations more effectively, resulting in the cessation of unhealthy behaviors such as not eating and binge-purging.

Anorexia Nervosa Nursing Care Plan 2

Impaired Parenting

Nursing Diagnosis: Impaired parenting related to family issues and history of deficient coping mechanisms secondary to anorexia nervosa as evidenced by unharmonious family relationships.

Desired Outcome: The patient will learn to cope appropriately with the family issues and resolve those.

Nursing Interventions for Anorexia NervosaRationale
Consult local resources such as family group therapy sessions, parent groups, and parental seminars as needed.    This approach may aid in the reduction of overprotective parenting, as well as the assistance or facilitation of the process of dealing with interpersonal conflicts and changes.
Prohibit other members of the family from intruding.    Improper involvement in family subsystems prevents individuals from successfully resolving conflicts.
Motivate and allow the patient to communicate his or her emotions.      Often, these families have not enabled their children to talk about their feelings freely, and they want assistance and freedom to understand and accept this.
Whenever the patient speaks, pay close attention.    This method makes the patient feel heard and understood. It gives them a sense of self-worth.
Encourage the patient not to answer every question asked by the family.    The patient has the right to privacy. He or she may choose not to respond to every one’s question, especially regarding his or her health condition.

Anorexia Nervosa Nursing Care Plan 3

Impaired Thought Process

Nursing Diagnosis: Impaired thought process related to mental health problems such as low self-esteem and a perceived sense of powerlessness secondary to anorexia nervosa as evidenced by perceptual abnormalities, including a failure to perceive hunger, fatigue, worry, and despair.

Desired Outcome: The patient will be knowledgeable about the cause of impaired thought processes and learn to deal with them

Nursing Interventions for Anorexia NervosaRationale
Take into account the patient’s impaired thinking ability.    This method enables caregivers to have more reasonable expectations of the patient and provide relevant assistance and advice.
Listen to the patient but avoid erroneous, illogical thoughts. The nurse should present reality succinctly and eloquently.  It is tough to reply logically when one’s mental ability is compromised biologically. The patient requires truth, but questioning the patient fosters distrust and dissatisfaction.  
Encourage the patient to follow the dietary plan strictly.    A healthy diet is critical for better neurological function.
Motivate the patient to be honest and open about what he or she feels, whether physical or emotional.    This approach will help the patient verbalize their feelings and learn to cope with them.
Assess the electrolytes and conduct kidney function tests.    Disparities harm cerebral performance and may need to be corrected before pharmacological treatments begin.

Anorexia Nervosa Nursing Care Plan 4

Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to insufficient food intake and self-inflicted vomiting after eating secondary to anorexia nervosa as evidenced by appalling muscle tone and too much-lost body weight.

Desired Outcome: The patient will comprehend the importance of proper diet and nutrition. The patient will also learn to sustain healthy body weight.

Nursing Interventions for Anorexia Nervosa Rationale
Inform the patient about the possible weight gain, so he or she will not be surprised.    This approach will prove the effectiveness of the treatment regimen.
Inform the patient that the bloating or swelling is just a temporary consequence of getting back on his or her usual eating pattern.  This approach aims to inform the patients about the physical changes that may happen. As a result, patients will participate in the care plan despite the changes.  
Observe the patient throughout meals and for one hour afterward.    To guarantee that the nutritional therapy regimen is followed. Foods are perceived as a medication for an anorexic admitted patient.
Maintain a limited menu available, and give the patient as much authority over his or her selections as feasible.  Patients who gain self-confidence and control their surroundings are more inclined to eat their preferred foods.  
Set limitations on fitness exercises and monitor the workout routine.Moderate exercise aids in the maintenance of muscular tone, body weight and the treatment of mental health problems.    

Anorexia Nervosa Nursing Care Plan 5

Risk for Deficient Fluid Volume

Nursing Diagnosis: Risk for Deficient Fluid Volume related to insufficient consumption of fluids secondary to anorexia nervosa

Desired Outcome: The patient will learn the importance of adequate fluid intake.

Nursing Interventions for Anorexia Nervosa Rationale
Track and manage vitals, pulse rate, mucous membrane condition, and skin turgidity.    This approach will help determine early signs of dehydration.
Remain aware of the amount and types of fluids consumed. Take precise measurements of urine production.    This method ensures that the patient is taking enough fluids to avoid dehydration.
Discuss with the patient the methods for stopping vomiting and the proper usage of laxatives and diuretics.  Helping the patient cope with the emotions that cause vomiting and the abuse of laxatives or diuretics will avoid further fluid loss.  
As directed, administer and monitor IV, TPN, and electrolyte supplements.      This approach is an emergency intervention to rectify water and electrolyte imbalances and avert cardiac dysrhythmias.
Determine the actions required to reestablish or ensure adequate fluid balance.Engaging the patient in the process of correcting fluid imbalances holds great significance.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon


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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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