1. Just because eating disorder is common, do not skip this topic for your exams.

The eating disorder topic sounds very easy. A patient diagnosed with eating disorder would typically have the mindset of the desire to be skinny. You are most likely to focus on the tougher topics and move on. That is not fair to your patients and you need to know how to handle a patient with an eating disorder by TRULY understanding what it is. Do not go based on what you heard because there are a lot of myths to eating disorders.

  • Anorexia nervosa and bulimia nervosa are the two most common eating disorders that you will come across.
  • Your patient CAN manipulate you and will do whatever it takes to not gain weight.
  • Counting calories is not always a bad thing. Counting calories to not meet the normal minimum requirements needed for the patient is definitely bad. Definitely pay attention to a patient diagnosed with bulimia nervosa when the patient finds a way to be alone. An example would be to go to the bathroom after eating.
  • Russell’s sign is important to look for in a bulimic patient. The knuckles would be bruised due to self-induced vomiting.

2. Understand that it can be fatal.

Eating disorder is a preventable disorder but if left untreated, it can be fatal. I was surprised to find out that 20% of patients with eating disorders die without treatment. With treatment, the mortality rate is 2 to 3%. (ANRED)

60% of patients with eating disorders have recovered with treatment so it is ESSENTIAL that you play your role in the patient’s life as a nurse to be there for the patient. (ANRED)

3. Know how eating disorders can affect electrolyte levels.

In anorexia nervosa, the patient would have lower potassium levels and metabolic alkalosis. In bulimia nervosa, the patient would have metabolic alkalosis from vomiting.

BE CAREFUL OF THIS: If a bulimic patient uses enema and laxatives, it is not considered metabolic alkalosis. This patient would have metabolic acidosis.